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A bronchoscopy is an essential tool for clinicians and health care providers treating patients with lung diseases. Since its introduction to clinical practice by Shigeto Ikeda in 1966, flexible bronchoscopy has become an essential tool in diagnosis and management of patients with lung diseases. Rigid bronchoscopy can be particularly helpful in therapeutic cases. This activity describes the indications, contraindications of bronchoscopy and highlights the role of the interprofessional team in managing patients with airway disorders. Objectives: Describe the technique of flexible and rigid bronchoscopy. Review the indications for bronchoscopy. Summarize the contraindications of bronchoscopy. Outline the importance of improving care coordination among the interprofessional team to enhance the delivery of care for patients undergoing bronchoscopy. Access free multiple choice questions on this topic.

A bronchoscopy is an essential tool for clinicians and health care providers treating patients with lung diseases.[1][2] Since its introduction to clinical practice by Shigeto Ikeda in 1966, flexible bronchoscopy has become an essential tool in the diagnosis and management of patients with lung diseases. Rigid bronchoscopy can be particularly helpful in therapeutic cases.

Medication-related complications:[8][9] An overdose of local anesthetics can result in central nervous system (CNS) toxicity like neuropathy, seizures, and coma. Methemoglobinemia Most sedative medications can cause hemodynamic effects, including low blood pressure or a low heart rate. General anesthetics may result in malignant hyperthermia and prolonged neuromuscular paralysis. Procedure-related complications: Bleeding: In most cases, bleeding is usually self-limited. The pulmonologists should carefully assess for hemostasis, and in the event of severe bleeding, prompt management should be instituted. Pneumothorax: In 1% to 3% of patients, pneumothorax may occur after transbronchial biopsies. Small pneumothoraces may be managed conservatively, while symptomatic and large pneumothoraces will require chest tube insertion and hospitalization. A tension pneumothorax results in hemodynamic instability and should be recognized even without imaging studies. Appropriate life-saving measures, such as chest tube insertion, should be undertaken immediately. Most pneumothoraces after bronchoscopy develop within the first hour of the procedure but can be delayed up to 24 hours. Appropriate instructions for the patient and appropriate follow-up should be arranged. Cardiac arrhythmias may also occur, especially in patients with pre-existing cardiac disease. Other potential complications of the procedure include trauma to the vocal cords, pneumomediastinum, hypoxia, and, rarely, death.

An interprofessional team skilled in the care of patients with airway and lung disease and adept at using bronchoscopy equipment is essential for performing bronchoscopy safely and managing complications. In addition to a skilled bronchoscopist, personnel include an endoscopy nurse and a respiratory therapist or technician trained to use bronchoscopy equipment. If general anesthesia is used for the procedure, additional personnel include an anesthesiologist and/or a nurse anesthetist. Many bronchoscopy suites also use rapid on-site cytologic evaluation of specimens by a pathologist or cytology technician.[10][11][12]