Bronchoscopy Practice Guidelines
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Before the Procedure
- Notify Family
- Gather all required personnel and equipment
- Perform a Time out*** Prior to starting the procedure a “Time out” must be performed and documented!
Required Personnel:
- Experienced Bronchoscopist (Physician/PA)
- Respiratory Therapist
- Nurse
- Page TBICU attending to let them know you are about to start the Procedure
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Suspect Pneumonia? Bronchoalveolar Lavage (BAL), Bronchoscopy Aspirates / Washings preferred over mini BAL when possible, feasible, and safe, however, mini-BAL is often an acceptable alternative- discuss with attending. |
Protective Gear: Bronchoscopist (The following protective gear must be worn by bronchoscopist and trainees to prevent transmission of infectious organisms from bronchoscopist to the patient, and from the patient to bronchoscopist and their clothing.)
- Sterile gloves
- Mask
- Hat
- Eye Protection
- Blue gown
- Clean Bronchoscope
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Bronchoscopy Elbow Adapter |
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In-line sterile specimen trap |
| Toomey Syringe |
Protective Gear: Other Personnel (The following protective gear must be worn by all in close proximity to the patient during the procedure)
- Mask and Hat
- Eye Protection
Equipment:
- Sterilized Bronchoscope
- Monitor
- Bite Block
- 20cc Sterile irrigation
- Blue “Chuck” to cover patient’s gown and create a clean field to work from
- Toomey syringe (for irrigation)
- In-line sterile specimen trap
- Suction
- Mechanical Ventilator
- Sedation (Administered by Nursing Staff)
- Lidocaine spray (Optional)
- (if used methylene blue 1% solution should be available in the event the patient develops Methemoglobinemia. Tx: Administer methylene blue 1% solution (10 mg/ml) 1 to 2 mg/kg intravenously slowly over five minutes followed by IV flush with normal saline.)
After the Procedure:
- Clean cart thoroughly between each use
- Obtain CXR
- Place Procedure note in the Electronic Medical Record
- Notify family of findings