Emergency Bronchoscopy in middle of the night

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Most Gastroenterology labs, at least inpatient, also have to assist with bronchoscopies. Does your endoscopy team come in during the night even for emergent bronchoscopies in the ICU? Does the pulmonologist wait on you to get there or does he get the cart himself and have respiratory therapy help him? Do you still come in to clean the scope? Please share with me how your hospitals handle this situation. Thanks, in advance, for responses.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Most Gastroenterology labs, at least inpatient, also have to assist with bronchoscopies. Does your endoscopy team come in during the night even for emergent bronchoscopies in the ICU? Does the pulmonologist wait on you to get there or does he get the cart himself and have respiratory therapy help him? Do you still come in to clean the scope? Please share with me how your hospitals handle this situation. Thanks, in advance, for responses.

Emergent bronchoscopies are handled by the on call resident or fellow and the overnight NP. In many cases, they'll bring the cart themselves and even set things up. (They don't, unfortunately, clean up after themselves.) The ICU nurse assists and cleans up the mess afterward. It takes about two hours to get a bronchoscope cleaned and returned to the ICU, and there's a central processing department that handles late night bronchoscope cleanings. If another emergent bronch is needed during that time, the ICU nurse (or the resident or NP) calls around to borrow one from another ICU. Or the fellow will just wander off and come back with one. The pulmonologist isn't involved unless it's an especially tricky patient or the fellow consults him/her. Certainly no one is called from home to come in and handle things.

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Thanks so much for the response. We don't have residents as we are not a teaching hospital but we do have O.R. staff in the building 24 hours a day so that is a good suggestion for them to clean the scope. Thanks so much!!!

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Specializes in Cerified Wound Ostomy Continence Nurse.

I am a procedural RN in an endoscopy lab in a large hospital. We work with the gi and pulmonary docs m-f, as well as take call nights, weekends and holidays. We will come in and perform emergent cases for/with pulmonary- making arrangements for crna attendance, prepping scopes, setting up and assisting bedside, then breaking it all down and processing the scope back in our suite. While we don't often come in for them overnight, a weekend therapeutic isn't unusual for a pt who's "drowning"... a rare foreign body retrieval, and sometimes a donor Bronch. We did a bronchoscopy for tracheostomy placement just yesterday!

Edit: we do have one doctor who will grab the NON video Bronch cart and perform a donor bronch himself if it's in the middle of the night - and we'll find the cart and the dirty scope in the middle of the lab the next morning. That's only happened once in the last three years, but I've heard he's done that a time or two in the past to save calling one of us in the middle of the night...

HTH

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Thank you so much for the response!

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Have any of you had experience with the Ambu Ascope3 Disposable Bronchoscopes? Our Respiratory Department is looking at this as an alternative to the pulmonologist calling us in during the night. This is the link : [COLOR=#0000ff]http://www.ambuusa.com/usa/products/clinical_studies/ambu%C2%AE_ascope.aspx[/COLOR]

They are reportedly around $300.00 each and the monitor/software that goes with it around $2,500.

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Specializes in Endoscopy.

I work in Endoscopy and we stock the standard scopes, including the Bronchoscopes. The ICU recently purchased disposable bronchs, but rarely use them because the Pulmonologists state they don't have a sufficient diameter for large plugs. (So we still have to come in on call now for ICU plugs)

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