Title:  Fiberoptic Bronchoscopy in ICU

Purpose: To establish clear guidelines for desired clinical outcomes and improved patient care b 

  • Standardization of the procedure
  • Enhanced competency should achieve
  • Optimal specimens for higher diagnostic yield

Definition: Fiberoptic Bronchoscopy in ICU is done for highly specific conditions:

  • Difficult intubation (trained staff only): not used as aid to failed endotracheal intubation.
  • Persistent lobar collapse that is refractory to physiotherapy.
  • Blood clots, thick mucus plugs or foreign bodies compromising the ventilation.
  • Diagnostic bronchoalveolar lavage (BAL) i.e. if Hospital acquired pneumonia (HAP)/Ventilator associated pneumonia (VAP) suspected.

Policy:  

  • This policy applies to all personnel in the pulmonogy and ICU division.
  • This is only to be used by skilled personnel and authorized by the duty consultant.
  • Expertise with the bronchoscope takes time:
    • Registrars are recommended to attend all bronchoscopic procedures in ICU by the consultant intensivist to become familiar with the
      • Anatomy of the tracheobronchial tree
      • Use of the flexible fiberoptic bronchoscope.
  • Bronchoscopy in ICU is available 24 hours/day 7 days/week to aid in the management of eligible patients requiring diagnostic or therapeutic intervention.
  •  Sources of admission can be:
    • Medical ICU
    • Surgical ICU
    • Coronary Care unit (CCU)
    • Emergency Room (ER)
  •  Any critically ill patient in KFHU who requires bronchoscopic intervention but can not be shifted to ICU for any reason.

 Procedure:

  •  Equipment
    • Flexible bronchoscope with its accessories
    • Suction machine
    • Light Source

Bronchoscopy Procedure reports are  completed by physician and must include

  • Date and time
  • Finding and impression
  • Mention all that is sent for analysis
  • Name and Signature of physician
  • Tolerance and condition of patient
  • Nature of specimen collected
  • Signature of nurse
  • Post procedure instructions

 Procedure : As per Guidelines

 Responsibility: 

  • Consultant on duty
  •  Endoscopy staff
  •  Respiratory therapist is responsible for the assistant during the procedure.
تاريخ النشر : ٠١ مايو ٢٠١٧
تاريخ آخر تحديث : ١١ مايو ٢٠١٧
المشاهدات : ٣٢٣