BRONCHOCOSCOPY Flashcards
How many scopes there is in house?
portable scope located in MICU in Pixis room placed above of the pixis tower.
The tower with video camara. located in the alcove in MICU
Name the supplies arranged at a bedside table to perform a bronchoscopy?
2, 10cc syringes (make sure they have a tip long and narrow enough to fit the opening of the valve inserted in the second overture of the scope) filled with 2cc Lidocaine + 8cc air) and resting in a sputum cup filled previously with a whole lidoca- ine bottle. 1**Blue bite block. to be used when patient is not intubated. 1 atomizer filled with lidocaine to numb the oral cavity and the patient through when inserting the scope. ***(go together)
1 blue connector device if patient is intubated which have three openings: one for ETT, one for two limbs ven/circuit, and the middle opening is for insertion of the scope. Remember that the opening that is attached to the ett is fitted with a clear plastic flexible valve. take off completely the in-line suction catheter.
1saline solution bottle, 3,, 20cc syringes. 1 blue bowl. (saline bottle emptied in the blue bowl and 3 syringes full filled with saline resting in the bowl ready for lavage)
Medications needed for a bronchoscopy
epinephrine vial (epi). 1/1000
lidocaine or Xylocaine 2% bottle
why is used epinephrine in a bronchocsopy
to stop bleeding or hemorrhage. it is a vasoconstriction so stop bleeding.
how do you get from pixis these medications?
overraide
how do you dispense epinephrine?
full fill 1cc syringe with epinephrine. then get two 0.9cc sodium chloride inj. bottles with the pistachio green lid. Inject half of the 1cc epi syringe into each one of the sodium chloride bottles, open then and fill a syringe of the deluded epi into a 10cc syringe and have it ready to instilled into the opening of the scope. remember that epi stops bleeding or hemorrhage. be attentive all the time if you see blood coming out from the scope.
what is BAL?
it stands for BRONCHO-ALVEOLAR-LAVAGE.
same as bronchoscopy but with alveolar lavage that involves more supplies such as:
1 swivel adapter which is the same as the blue connector if patient is intubated. and a blue bite block if not.
xylocaine and epinephrine arranged as explained before (override them in pixis)
3 or 4 syringes of 20cc filled with saline sol. resting in a blue bowl filled with extra saline solution
get ready aspiration needles:
- asp. needle
- radial jaw….(cytology or for microbiology sample)
- cytology brush. internist operator usually cut the tip of the brush and drop in the cytology bottle as sample. or cut with the the scissors scope blades a tisue sample which are placed into the long tube red label.. all needle long brushes are treadede into the second opening botton of the scope.
documentation.
white, pink and yellow sheets to be filled by the internist performeing bronchoscopy. respiatory office keeps the yellow and for charge.
when should be used the portable scope?
only in emergencies and on request
where do you find extra bronch supplies?
MICU, in pixis room opossite to pixis machine.
What is the buffer?
Ask para que sirve
g
g
How do you call the red box that goes down in the bronch tower?
Tackle box.
And it has to be stock every time you used. Before and after so you are sure it has all that is needed for a emergency or not a bronchoscopy.
list the procedures to clean bronchoscopes
policy: equipment is to be clean immediatelly after each procedure. standard precautions are always maintaned and should we use gloves, fluids resistants gowns, mask and protective eyewear or shield.
1. - immediatelly after procedure suction saline and air for about
10 secs. Remove disposable suction valve and disposable
biopsy valve to discard. place bronchoscopy in a covered
container for transport to utility area.
- fill utility sink with water. totally sumerge scope and perform
leak test.
3.- wash entired scope under water with hospital approved
enzymatic cleaner using 4X4 gauze sponge. With cleaner
adaptors attached. Suction alternating cleaning solution
and air.
4.- Brush suction and biopsy channels with cleansing brush, and
the suction cleansing solution, alternating with air for 10 to
15 secs.
5.- rinse bronchoscopy in clean water, suctioning water and air as
above for 10 to 15 seconds.
6.- place scope in washer-sterilizer, connect all adapters and
commence twenty minute cycle or glutaraldehyde 2%,
followed by rinse cycle.
7.- when cycle completed, press air button on for one minute,
instill 10 cc of 70% isopropyl through port on washer and
allow air to run up for 1 to 2 min. until no fluid is seen coming
from distal tip of scope.
8.- hang bronchoscopy to air dry, or connect to loww flow oxygen
source, or place in drying cabinet.
what are the instruction for accesing bronchoscope medications
such as Lidocaine and epinephrine in PIXIS.
- ID as normaly I do
- go to main manu
3 go to inventory - go to select by med
- scroll down the medication and highligthted
- select inventory selection
the drawer open and take the medication out
