Procedure Information/FAQ

To ensure your procedure runs smoothly, please follow these important guidelines:

Arrival Time:
At the time of your office visit when your procedure is booked, you will be given an estimated arrival time for your procedure. This is subject to change as the date of your procedure approaches, so please follow the arrival time given to you by the nurse that confirms your appointment ~1 week prior to the procedure.  This helps our team prepare and ensures everything is ready when you arrive.

Medications:
While we have a list of your current medications, please bring an up to date list of your prescriptions and over-the-counter medications (including vitamins and supplements). This ensures we have the most accurate information about your medications.

• Heart, blood pressure, seizure, and breathing medications: Please take these as usual, unless your doctor advises otherwise. If you take them in the morning, make sure to take them at least 4 hours before your scheduled arrival time.
• Blood thinner medications (such as Eliquis, Warfarin, Plavix, Aspirin, Lovenox, Pradaxa, etc.): Follow the specific instructions given by your doctor.
• Non-essential medications: Discontinue any non-essential vitamins, iron supplements, fish oil, and fiber medications 7 days before your procedure.
• Weight loss medications: Do not use Phentermine or any other weight loss medications for 2 weeks before your procedure. Do not use injectable weight loss medications 1 week before your procedure.
• Recreational drugs: Please refrain from using recreational drugs prior to your procedure.
• Tobacco products: Do not use tobacco products 6 hours prior to your procedure.

Accompaniment:
For safety reasons, you must have a responsible adult drive/accompany you home after your procedure. This person must remain at or near the facility during the procedure and provide their name and contact number at check-in.

Pregnancy Testing (able to bear children):
If you are a woman that is able to bear children , you will be asked to provide a urine sample for pregnancy testing. The urine sample will be collected when the nurse calls you back to the endoscopy suite from the waiting room. Please keep this in mind as you plan your bathroom trips. If you have had a hysterectomy or tubal ligation, this step is not necessary.

Insurance and Personal Information Updates

If there have been any changes to your insurance information, please provide the updated details to the receptionist upon arrival. Additionally, if your name, address, phone number, or any other personal information has changed since your last visit, please inform the receptionist. If your procedure requires a copay or payment, we’ll collect it at this time. You will receive a separate bill for anesthesia services after your procedure

Electronic Documentation

You will be asked to review and sign the following documents:

Business Consents:

• Authorization to Release Information
• Financial Policy
• Patient’s Rights and Responsibilities
• Receipt of Privacy Practices
• Ownership Statement

Procedure Consent:

• Colonoscopy
• Esophagogastroduodenoscopy (EGD)
• Esophageal dilation 
• Flexible sigmoidoscopy 
• Anesthesia Consent

Once you’ve checked in, please have a seat in the lobby and wait for the pre-op nurse to call your name. It is important that you do NOT eat or drink anything while waiting. Nothing by mouth (including ice chips, chewing gum, or hard candy) within 4 hours before. For people with the ability to bear children, please also note that a urine sample will be collected when the nurse calls you back to the endoscopy suite. 

Delays can occur on procedure days due to factors like case complexity and patient care needs. We work as efficiently as possible while keeping safety first. Thank you for your patience and understanding. To maintain a respectful environment, abusive or disrespectful behavior toward our staff will not be tolerated.

Pre-Procedure

Arrival and Check-in: When you arrive, the nurse will call you into the pre-op area when they are ready for you. Your ride will be asked to wait in the lobby or in your recovery room until your procedure is complete. If you need any special assistance during the pre-op process, please inform the nurse so we can accommodate your needs.

Medication Review: The pre-op nurse will ask you about all your medications, including any taken the morning of the procedure. They will review this information with you, updating your medical chart as needed. Please be prepared to provide details on the timing and dosage of any medications you’ve taken.

Preparation and Medical History: The nurse will also ask about your prep instructions and when you last ate or drank. It is important that you have nothing to eat or drink for 4 hours prior to your procedure. Additionally, the nurse will review your medical history, including any allergies and reactions to medications and food.

Procedure Overview: The nurse will explain the procedure, the sedation process, and basic discharge instructions. This is a great time for you to ask any questions about what to expect during and after the procedure. An IV will be started for sedation.

For Diabetic Patients: If you are diabetic, please let the nurse know so we can check your blood sugar before the procedure.

Pre-Procedure Consultation: You will have the opportunity to speak with the Nurse Anesthetist and your Physician before the procedure begins.

Personal Belongings: Please leave your phone, purse, wallet, electronic devices, dentures, and glasses with your ride. Electronics are not allowed in the patient care area.

During the Procedure

You will be taken on a stretcher to the Procedure Room, where your Physician will perform the procedure. Sedation will be administered by a Registered Nurse or Nurse Anesthetist, who will monitor you closely throughout the procedure.

Recovery After the Procedure

Once your endoscopy is complete, you will be moved to the recovery area for observation and care. Our team will monitor you until most of the effects of the medication have worn off, ensuring your comfort and safety as you recover.

Post-Procedure Care

As you become more alert, your driver or family member (if you’ve agreed for them to join you) will be invited into the recovery area. Your nurse will check your ability to swallow and, if appropriate, offer you a drink.

The physician will review the results of the procedure with you and answer any questions you may have at this time. Your nurse will remove your IV and go over your written discharge instructions, as directed by your doctor.

Once you’ve gotten dressed and signed your discharge consent, one of our staff members will assist you to your vehicle.

Post-Procedure Recommendations

It is important that you do not drive, operate heavy machinery, or make any important decisions on the day of your procedure. You should be able to resume normal activities the following day. Additionally, a member of our team will attempt to call you the next day to check on your recovery.

Conscious Sedation

What is Conscious Sedation?
Conscious sedation is used to help you relax during your procedure. You may remain awake, but you will feel drowsy or even fall asleep. You will still be able to breathe on your own and respond to verbal cues or touch. After the procedure, you may not remember much, but you will wake up easily when spoken to.

The medications we commonly use for conscious sedation are Versed (a sedative) and Fentanyl (a pain reliever). These will be administered through an IV by a Registered Nurse, under the direct supervision of your physician. While you may feel sleepy or even sleep through the procedure, you can be awakened easily when touched or spoken to.

You will be closely monitored throughout the procedure and during your recovery. Once you are ready, you will be cleared for discharge.

Important Aftercare:

• Cognitive and motor function: Conscious sedation may affect your memory, coordination, and decision-making abilities. It is essential that you have a responsible adult drive you home after the procedure.
• No taxis or buses: You will not be permitted to take a taxi or bus home alone unless a designated responsible adult is accompanying you.
• Rest is important: We also recommend that you rest and avoid making any important decisions or working on the day of your procedure.

If you have had any allergic reactions or adverse responses to Versed or Fentanyl in the past, please inform your nurse and/or doctor prior to the procedure.

Deep Sedation

What is Propofol?
At our facility, we may use a deep sedation with a drug called Propofol. This sedation method has several advantages over conscious sedation and may even improve the quality of your examination. 

Benefits of Propofol:

• Rapid onset: Propofol works quickly, so you will feel relaxed almost immediately.
• Short duration: It leaves your system quickly, so you will likely feel little to no residual drowsiness after the procedure.
• No pain: You will be completely unaware of the procedure and will not experience pain during the procedure 
• No nausea: Unlike other sedatives, Propofol generally does not cause nausea or vomiting.

How is Propofol administered?
Propofol is given by an anesthesiologist or nurse anesthetist, who will stay with you throughout your procedure. Your blood pressure, heart rate, and breathing will be carefully monitored.

Please note that there is a separate fee for Propofol administration, billed by Mountain Regional Anesthesia, who will file with your insurance where applicable.

Contraindications to Propofol
Propofol may not be suitable for individuals who are allergic to Propofol Injectable Emulsion or have allergies to eggs, egg products, soybeans, or soy products. Please inform your nurse if you have any of these allergies.

Robinul

What is Robinul?
Robinul is a medication that may be given through your IV in the pre-procedure room. Its main purposes are to reduce oral secretions and to slow down the peristalsis of the colon while you are deeply sedated, helping to minimize any risk factors during the procedure. You may experience a side effect of a very dry mouth.

If you have conditions such as severe glaucoma or prostate enlargement with associated urinary retention, please inform your nurse before the procedure. In these cases, your doctor and anesthesia provider may choose not to administer Robinul.