BRONCHOSCOPY.ppt

BRONCHOSCOPY PINTU DAVID DEPT. OF. PULMONARY MEDICINE C M C INTRODUCTION Bronchoscopy is the general term used to describe the insertion of a visualization instrument ( endoscope ) into the bronchi. The purpose of bronchoscopy are to inspect the airway, remove objects from the airway, collect samples from the airway, and place devices into the airway. TYPES There are two different types of bronchoscopes : 1.Rigid tube bronchoscope. 2.Flexible fiberoptic bronchoscope Rigid Tube Bronchoscope Rigid Tube Bronchoscope It is an open metal tube with a distal light source and a port of attaching O2 or ventilating equipment. It is most often used by otorhinolaryngologist or Thoracic surgeons It has several disadvantages Flexible Fiberoptic Bronchoscope Flexible Fiberoptic Bronchoscope The Fiberoptic bronchoscope has gained popularity over the years as a result of versatility and ability to access very small air ways. BRONCHOSCOPY PROCEDURE There are several steps involved. They are; 1.Pre-medication 2. Equipment preparation 3. Airway preparation 4. Monitoring PRE-MEDICATION Bronchoscopy is an uncomfortable procedure… to decrease anxiety the patient should be premedicated. Tranquilizers such as benzodiazepines example valium is used. Atropine is used to dry the patient’s airway,promotes anesthetic deposition,aids visibility and can reduce procedure time. PRE-MEDICATION… 4.Atropine may also decrease vagal responses such as bradycardia and hypotension. 5.Narcotics analgesics such as morphine or fentanyl may also be used during the procedure. 6. Bronchodilator should be administered before the procedure. EQUIPMENT PREPARATION All the equipment must be thoroughly checked for function, tight connections, and integrity , this is true for specially small parts and connectors, which can be aspirated if they loosen and disconnect. AIR WAY PREPARATION The goals of airway preparation is to prevent bleeding, decrease cough and gagging and decrease pain. Lidocaine, lignocaine,a