Mod 13 Bronchoscopy Flashcards
What is the primary purpose of a Bronchoscopy?
To view the airways and check for any abnormalities
Insert image for slide 5
What Airway anatomy is evaluated/indicated for assessment for Flexible Bronchoscopy?
- Fistulas
- Hemangiomas or tumours
- Stenoses or strictures
- Tracheal bronchus
- Vascular rings
- Congenital anomalies
What are indications for Bronchoscopies?
- Insert image from slide 6
- Airway anatomy evaulation
- Biopsy
- Cytopathology
- Microbiology
- Foreign body aspiration
- Functional airway evaluation
- Inhalation injury
- Therapeutic use
For diagnostic purposes, what are the most common indications for Bronchoscopy?
- Persistent or recurrent respiratory symptoms (i.e stridor, abnormal voice)
- Persistent abnormalities on CxR
Absolute contraindications for bronchoscopy?
- Absence of informed consent
- Cardiovascular instability
- Inability to oxygenate the patient adequately
- Uncontrolled coagulopathy or bleeding
- When risks outweigh benefits
Relative contraindications for bronchoscopy s?
- Severe bleeding diatheses or coagulopathy
- Hypercapnia w/acidosis
- hypoxemia
- Severe pulmonary hypertension
- Severe upper airway obstruction
- Severe superior vena cava obstruction
- Uncooperative patient
- Uncontrolled asthma
- Uremia
Bleeding control bronchoscopy
epinephrine 1:1000 or cold neb
Topical anesthetic for bronchoscopy
Lidocaine
What is used for Bronchospasm control in bronchoscopy?
Ventolin
Secretion reduction in bronchoscopy
Anticholinergics (atropine)
SpO2 goal bronchoscopy
> 95%
Saline dose bronchoscopy
3-5 aliquots of 1ml/kg
Bronchial brushings
Obtaining a sample of a suspected lesions in the lungs
- Use brush and brush 5-10 times.
Adult saline dose bronchoscopy
30-60ml 3-5x
BAL (bronchoalveolar lavage)
Bronchoscope wedged into position f selected segment, washed with saline and suctioned out
- Use suction and saline
Bronchial biopsy
Used to obtain samples from lesions
- Use alligator clips
Complications in bronchial biopsy
Bleeding or pneumothorax
Bronchoscopy needle aspiration
Wang needle
allows to get tissue samples otuside surface of bronchioles
Rigid bronchoscopy
used to remove obstructions or large amounts of secretions from the respiratory tract
Bronchoscopy intubation
Used for difficult or C-spine precautions
Monitoring in bronchoscopy
BP, HR, SpO2
- Frequent inspection and auscultation
Common location BAL
lingula
Common complications bronchoscopy
Cough fever transient hypoxia
La Places law
- As pressure increases, the surface tension increases
- As radius decreases, pressure and surface tension increase
