Table 2.
Overall analysis of responses from gastroenterologists [N=428]
| N (%) | |
|---|---|
| Resource availability | |
| Sub-specialty services | |
| ENT | 70 (16) |
| Surgery | 57 (13) |
| Radiology | 101 (23) |
| Support staff | |
| Gastroenterology technician | 186 (42) |
| Endoscopy nurse | 213 (48) |
| Resource utilization | |
| Radiologic tests | |
| Chest x-ray | 254 (42) |
| Esophagogram | 91 (21) |
| Upper gastrointestinal (GI) series | 21 (5) |
| CT scan | 10 (2) |
| Location of EFI removal | |
| Emergency Room (ER) | 123 (28) |
| Gastroenterology lab | 260 (59) |
| Operating Room | 240 (55) |
| Clinical decision making | |
| Pharmacologic and non-pharmacologic interventions | |
| Peripherally acting agents | 6 (1) |
| Smooth muscle relaxants | 230 (52) |
| Benzodiazepines | 23 (5) |
| Calcium channel blockers | 12 (3) |
| Nitrates | 16 (4) |
| Gravity | 53 (12) |
| Effervescence | 15 (3) |
| Time from presentation to ER to start of upper endoscopy (EGD) (Hours)# | 5 ± 4 |
| Anesthesia | |
| General anesthesia with intubation | 305 (69) |
| Monitored anesthesia without intubation | 108 (25) |
| Conscious sedation | 105 (24) |
| Esophageal Food bolus disimpaction technique | |
| Retrieve | 148 (34) |
| Push | 55 (13) |
| Both | 233 (53) |
| Esophageal Food Impaction (EFI) removal devices | |
| Snare | 248 (56) |
| Forceps | 249 (57) |
| Net | 350 (76) |
| Graspers | 250 (57) |
| Baskets | 178 (40) |
| Suction cup | 121 (28) |
| Biopsy practice | |
| Yes, always obtain esophageal biopsies irrespective of endoscopic findings | 147 (34) |
| Only if I observe abnormal endoscopic findings | 220 (51) |
| No, I do not obtain biopsies | 61 (14) |
| Number of biopsies# | 5 ± 3 |
| Post EFI removal | |
| Wait for biopsy results without starting any medications | 196 (46) |
| Start medications irrespective of how the esophagus looks on endoscopy | 96 (23) |
| Start medications only if the esophagus looks abnormal on endoscopy | 130 (31) |
| Dilation during EFI removal | 197 (46) |
| Post-EFI removal immediate therapeutic management | |
| Carafate | 54 (12) |
| Proton-pump inhibitor (PPI) therapy – Regular dose | 200 (45) |
| PPI therapy - High dose | 175 (40) |
| Inhaled/swallowed steroids | 20 (5) |
| Swallowed steroids | 20 (5) |
| Post-EFI removal long term management | |
| Follow up | |
| No, I don’t follow up | 315 (72) |
| Only if I observe gross endoscopic abnormalities in the esophagus | 37 (8) |
| Only if the biopsies are abnormal | 74 (17) |
| Yes, always | 8 (2) |
| Duration to clinic follow up follow-up (Months) # | 1.52 ± 2.08 |
| Follow-up EGD | 176 (41) |
#
Mean ± SD.