Bronchoscopy Flashcards
One of the major advantate of RIGID bronch
Large OPEN CHANNEL
Size range of RIGID Bronch
3 to 7 mm or larger (DIAMETER)
Length: 20 to 50 cm
Defined by the diameter of THE LARGEST INSTRUMENT that will pass
GLASS ROD telescope
Need for GA
With HOLES allowing ventilation of the CONTRAlateral lung
*side and distal tip
RIGID BRONCH
Flexible bronch is defined by their
Usual size of pediatric bronch nowadays
OUTER diameter
2.8 mm diameter or 3.5 mm
This instrument foces the patient to breathe AROUND the instrument
Rely on fiber glass to transmit image
FLEXIBLE bronch
INDICATIONS OF BRONCH
Helpful in assessment of tracheostomy and its dynamics and position
Flexible bronchoscopy
Assessing aspiration from post larynx to cervical trachea
RIGID BRONCH
Assessing Tracheostomy from post larynx to SUBglottic
RIGID bronch
Indications of bronch by symptoms
*CSA
COUGH >1 month
Stridro >2 weeks
Atelectasis >6 weeks
Contraindications for bronch
NO ABSOLUTE
But with relative contraindications:
Bleeding <50, 000
Massive hemoptysis
Severe bronchospasm, obstruction
Hypoxemia
Procedure to distinguish transplan rejection vs infection
Tranbronchial biospy
Volume of BAL adult vs pedia
5 aliquots of 50 mL
3 aliquots of 100 ml
Pedia
10 to 20 ml in 2 to 4 aliquot (regardless of wt)
Adjust volume based on FRC and body weight (PAPP in 5-20ml fractions)
Adjust volume 3ml/kg (PAPP if less than 20 kilos, divided into 3 equal fractions; if >20kg, 20 ml fractions
Duration of bal
1-3 minutes
Lowest possible platelet count where BAL can be done safely
20,000 platelets/ml