Upper gastrointestinal endoscopy should be performed by an experienced operator to minimise the duration and trauma of the procedure, and to minimise gaseous distension of the gut.

1. The patient is usually placed in a lateral position though can be supine if intubated.

2. Increase FIO2 and ventilator pressure alarm settings. Consider increasing sedation and adjusting ventilator mode.

3. Monitor ECG, SPO2, airway pressures and haemodynamic variables throughout. If patient is on pressure support or pressure control ventilatory modes also monitor tidal volumes. The operator should cease the procedure, at least temporarily, if the patient becomes compromised.

4. At the end of the procedure the operator should aspirate as much air as possible out of the gastrointestinal tract to decompress the abdomen.


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