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Bret T. Petersen, MD, FASGE

Associate Editor
Pancreatobiliary

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Biography

Bret T. Petersen, MD, FASGE is Professor of Medicine in the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, Minnesota. His practice is focused in the Mayo Pancreas Clinic and the Advanced Endoscopy Group. His professional interests include pancreatic and biliary diseases, performance and outcomes of ERCP, and delivery of endoscopic services. At Mayo, Dr. Petersen is a past Director of Endoscopy and has served on multiple clinic and foundation committees. He has directed numerous American Society for Gastrointestinal Endoscopy (ASGE) and Mayo courses, particularly related to the performance of ERCP. He has received the Mayo Award for Excellence, GI Fellows Award for Outstanding Teacher, and Department of Medicine Laureate Award (GI), as well as the Master Endoscopist Award of the ASGE. Dr. Petersen is the incoming Secretary for (ASGE) and a past Chair of the Technology and Quality Assurance in Endoscopy committees.

Disclosures

Consultant 

Boston Scientific 

Advisory Board 

Ethicon/J & J

 

Summaries

“May” Becomes a “Should” for Facial Protection During Endoscopy

Bret T. Petersen, MD, FASGE reviewing Johnston ER, et al. Gastrointest Endosc 2018 Nov 1.

Use of personal protective equipment (PPE) appropriate to the risk of exposure is advised for all patient interactions and interventional procedures. The risk of staff exposure to infectious organisms during various endoscopic procedures is unknown. In this prospective study, face shields worn by four gastrointestinal endoscopists were swabbed before and after 239 endoscopy sessions involving 1100 procedures. Control swabs from face shields on the wall, distant from the patient, were also obtained. After incubation for 48 hours, pre-session sample positivity was equivalent between faces and controls (2%-4.8%, not significant) but significantly lower than post-session samples, whether obtained from the face (45.8%, P < .001) or the wall (21.4%, P < .001). Significant or definite exposure (>15 CFUs) to the face occurred at a rate of 5.6 per 100 half-day endoscopy sessions and to the wall, 6 feet away, at 3.4 per 100 half-day sessions.

Comment:

Most gastrointestinal endoscopists do not wear the full regalia of PPE made available to them by unit management. While gowns and gloves are universal and eye protection is usual, face masks or shields, booties and head coverings are used with diminishing frequency during general endoscopic procedures. Foot coverings are more common in pancreatobiliary procedures, related to the common leakage of bile and secretions through used biopsy port caps. This study provides the basis for the admonition to protect your face during endoscopy. Unrecognized facial exposure to potentially infectious microbes during endoscopy was not uncommon and risks real acquisition of infectious diseases during work.

Note to readers:
At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Bret T. Petersen, MD, FASGE
Bio and Disclosures

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Citation(s):
Johnston ER, Habib-Bein N, Dueker JM, et al. Risk of bacterial exposure to the endoscopist’s face during endoscopy. Gastrointest Endosc 2018 Nov 1. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2018.10.034)