Checklist for a bleeder case:

Scope and Device Setup

1. Call Team to set up the endoscope/discuss case with anesthesia provider

2. Scopes Requested:

- 1T scope

- Regular GIF scope

 Medications and Injections

1. Epinephrine Preparation - 1:10000 concentration

2. Prepare: Erythromycin 250mg or reglan 10mg if qtc permits

3. based on patient history (cirrhosis/portal hypertension/varices) determine need for octreotide (intravenous bolus of 50 to 100 micrograms followed by 25 to 50 micrograms /hour intravenously maintenance)

 Hemostatic Clips and Devices

1. Clips: (click here for table with different clips)

- Resolution 360 clip

- Resolution 360 Ultra clip

- Dura clip

2. Hemostatic Devices:

- Hemospray (setup video) (how to use video)

- Purastat (prep and priming video)

- Nexpowder (setup video)

- Ovesco clip:(setup video) (types/sizes video) (how to deploy video)

- "A" clip (atraumatic)

- "T" clip (traumatic, typically for more aggressive needs)

- GC clip (gastric perforations, if applicable)

 Electrosurgical Equipment

1. ERBE Machine

2. Bipolar Cautery Probe - ensure availability (does not require a grounding pad, unlike monopolar or APC)

3. Injector Needle Options:

- Bipolar cautery probe with injector

- Steris injector needle (standalone option if bipolar cautery is not needed)

4. Clot retrieval options

   - Roth net (for capturing soft or fragmented material).

   - Rat-tooth or alligator forceps.

   - Polypectomy snare

 Basic Procedure Setup

1. Personal Protective Equipment (PPE):

- Gown

- Face mask

2. Procedure Basics:

- Bite block

 System and Equipment Checks

1. Provation Check - verify images are being captured.

2. Screen Setup:

- Ensure both screens are present.

- Verify both screens are operational.

3. System Irrigation and Suction - test and confirm functionality.