Bronch's

Bronchoscopy is done in our unit and in ICU in emergency cases. You just have to bring the machine and the scope and accessories needed. It's a fast procedure, some with an x-ray guide. Patient is on oxygen.

Patient's oro-nasal passage are locally anesthetized and the doctor sometimes inject a local anesthesia in the throat. Patient is given sedation. We lubricate the scope with xylocaine gel and push some xylocaine sol while we enter the trachea. it is suctioned as the doc goes in.. then we flush some saline, take some biopsies or specimen using the trap. then the doc suctions the remaining saline and some secretions and pulls out the scope.

We do them on our unit. Respiratory Therapy assists the MD, the RN is responsible for sedation and Pt monitoring. The Pt's seem to tolerate them quite well, often requiring less sedation than for a colon, but they make us nervous. Not so much if it'a just BAL or brushings, transbronchial biopsies carry the risk that a blood vessel will be hit. Bronch's are responsible for every one of the few emergencies I can remember on my unit. In every case we broke out the code cart, just for the respiratory tray, and intubated the Pt. One went home, one was admitted, one went to the unit. Their recovery time is usually extended because their respiratiry status is usually a little compromised and you wind up watching them for longer, and they may need a CXR if biopsies were done, to rule out pneumothorax.

Is anyone doing bronch's in their endo units?

if so would you be willing to talk to me about the whole process. presently they are done in our OR, but there is talk of moving them to the Endo suite.

thanks

We also do bronch's in our endo suite. We do on the average of 12 per week and by far they are our most time consuming patients. I agree 100 % with all the comments Kimtab said in her post. They are always the sickest patients and most of the respiratory/cardiac arrests we have will be in the bronch area. If you need more detailed info you can pm me I'd be happy to help.

Sandra

we do bronch's in our endo unit. what exactly are you wanting to know? we admit and discharge them the same as an endoscopy procedure. we are required by our epidemiologist at our hospital to wear our tb mask or respirator during bronchoscopy.

is anyone doing bronch's in their endo units?if so would you be willing to talk to me about the whole process. presently they are done in our or, but there is talk of moving them to the endo suite.

thanks

Is anyone doing bronch's in their endo units?

if so would you be willing to talk to me about the whole process. presently they are done in our OR, but there is talk of moving them to the Endo suite.

thanks

We do anywhere from 1-4 bronchs a month on our unit. They're a bit more trouble because for some pts. we have to call X-ray to bring the fluoro equipment over and place the pt. on the fluoro table. We have to turn on the neg. isolation for the room. 2 nurses (occ. 3) and the X-ray tech are present. One nurse. assists the doc., the other monitors and sedates, and the last one does the biopsies (which are the most time consuming part of the procedure). Occ. we'll do a patient who is very sick and has trouble maintaining his O2 sat but most of our bronchs are diagnostic and the patient is just like any other endo pt. The pulmonologist who does most of ours is experienced and knows what he's doing. He's patient and is happy to talk us through if we don't know exactly what to do or if it's a new nurse,etc. We compiled an easy to refer to instruction manual on how to set up the bronch equipment, what stuff to use, and how to package and label the specimans. That helped me alot when I was learning. Good luck!

We do Bronchs in our Endo Suite too. We also do TEE's. Anybody else doing these? The Cardiology Dept doesn't want to do it, but they still get the revenue. Sounds fair huh?!?! Oh well, I still get paid by the hour.

Jen