LITFL go into considerable detail with this item.
From CICM, there are a couple of bronchoscopy questions:
- Question 1 from the second paper of 2005 (anatomy of the bronchial tree)
- Question 5 from the second paper of 2009 (safety of bronchoscopy in an infectious patient)
Indications for fiberoptic bronchoscopy
Diagnostic:
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- Visual diagnostic inspection of the tracheobronchial tree
- Biopsy collection
- BAL
- Washings/brushings for cytology
Therapeutic:
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- difficult intubation (e.g. awake fiberoptic intubation)
- suction of secretions or blood
- guide placement of a percutaneous tracheostomy
- confirm position of a dual-lumen tube
- Control bleeding (haemoptysis)
Complications of bronchoscopy:
- Accidental extubation
- Airway trauma
- Bronchospasm
- Loss of PEEP
- Damage to the expensive bronchoscope
- Infection (poorly sterilised bronchoscope)
- Infection of operator (aerosolised patient lung filth)
Cleaning your bronchoscope:
- Wipe scope from head to tip
- Place distal tip in detergent and aspirate through suction channel
- Remove the suction adaptor valve and place in the detergent.
- Attach the suction cleaning adapter to the instrument channel port and place distal end into the detergent solution and depress the suction button for 30 seconds.
- Then separate the endoscope from the light source
- The endoscope can now be autoclaved
The swivel connector for bronchoscopy
- allow ventilation without gas leak during bronchoscopy or suctioning
- disposable plastic
- right angled design for greater patient comfort
- 22 mm / 15 mm universal connectors
- airway access port is self sealing or with removable cap
- Causes a loss of PEEP when the circuit is broken
- extra resistance and dead space in the circuit