Bronchoscopy - Revision history

Rhawthorne at 20:41, 6 February 2025

2025-02-06T20:41:05Z

← Older revision		Revision as of 13:41, 6 February 2025
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	** Succinylcholine or intermediate acting NDMR		** Succinylcholine or intermediate acting NDMR
	** LTA lidocaine		** LTA lidocaine
	* If doing a MAC, have supplies ready to secure ~~aware~~ if needed		* If doing a MAC, have supplies ready to secure airway if needed

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===

Chris.Rishel at 07:48, 5 April 2022

2022-04-05T07:48:23Z

← Older revision		Revision as of 00:48, 5 April 2022
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	{{Infobox surgical procedure		{{Infobox surgical procedure
	\| anesthesia_type = ~~GA vs.~~ MAC		\| anesthesia_type = General or MAC
	\| airway = ETT (use > 8.0 tube) / LMA		\| airway = ETT (use > 8.0 tube) or LMA
	\| lines_access = PIV ~~x 1~~		\| lines_access = PIV
	\| monitors = Standard		\| monitors = Standard
			5-lead ECG
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative =

Chris.Rishel at 06:05, 22 February 2022

2022-02-22T06:05:26Z

← Older revision		Revision as of 23:05, 21 February 2022
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	!System		!System
	!Considerations		!Considerations
			\|-
			\|Airway
			\|
	\|-		\|-
	\|Neurologic		\|Neurologic

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:45:37Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:45, 21 February 2022
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	\|In patients with CAD, the adrenergic response during airway manipulation could precipitate myocardial ischemia. Breakthrough sympathetic responses can be managed with beta blockers or short acting narcotics.		\|In patients with CAD, the adrenergic response during airway manipulation could precipitate myocardial ischemia. Breakthrough sympathetic responses can be managed with beta blockers or short acting narcotics.
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|High incidence of COPD and respiratory disease. Stridor at rest could suggest airway narrowing.		\|High incidence of COPD and respiratory disease. Stridor at rest could suggest airway narrowing.
	\|-		\|-

Chris.Rishel at 21:12, 21 February 2022

2022-02-21T21:12:32Z

← Older revision		Revision as of 14:12, 21 February 2022
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			[[Category:Airway procedures]]

Barrett.Larson at 00:43, 13 July 2021

2021-07-13T00:43:47Z

← Older revision		Revision as of 17:43, 12 July 2021
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	\|-		\|-
	\|Cardiovascular		\|Cardiovascular
	\|		\|In patients with CAD, the adrenergic response during airway manipulation could precipitate myocardial ischemia. Breakthrough sympathetic responses can be managed with beta blockers or short acting narcotics.
	\|-		\|-
	\|Respiratory		\|Respiratory
	\|High incidence of COPD and respiratory disease.		\|High incidence of COPD and respiratory disease. Stridor at rest could suggest airway narrowing.
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
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	=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===		=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===

	* Glycopyrolate to ~~dray~~ the airway		* Glycopyrolate to dry the airway
	* Albuterol if wheezing noted pre-operatively		* Albuterol if wheezing noted pre-operatively
	* Avoid sedative premedication in elderly or patients with upper airway obstruction		* Avoid sedative premedication in elderly or patients with upper airway obstruction

Barrett.Larson at 21:28, 12 July 2021

2021-07-12T21:28:43Z

← Older revision		Revision as of 14:28, 12 July 2021
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	\|-		\|-
	\|Respiratory		\|Respiratory
	\|High incidence of COPD and ~~decreased~~ respiratory ~~reserve~~.		\|High incidence of COPD and respiratory disease.
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
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	\|-		\|-
	\|Hematologic		\|Hematologic
	\|		\|Patients with malignancy may have anemia or coagulopathy
	\|-		\|-
	\|Renal		\|Renal
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	\|-		\|-
	\|Other		\|Other
	\|		\|Careful assessment of teeth and documentation of any loose or missing teeth. Inform patients that dental trauma may occur from surgical instrumentation.
	\|}		\|}

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	* Glycopyrolate to dray the airway		* Glycopyrolate to dray the airway
	* Albuterol if wheezing noted pre-operatively		* Albuterol if wheezing noted pre-operatively
			* Avoid sedative premedication in elderly or patients with upper airway obstruction
	* Patients with significant respiratory disease may need specialized ventilation techniques, such as jet ventilation, apnea intermittent ventilation, high-flow nasal cannula		* Patients with significant respiratory disease may need specialized ventilation techniques, such as jet ventilation, apnea intermittent ventilation, high-flow nasal cannula
	* A plan (and backup plan) for securing the airway should be discussed with surgeon prior to induction, particularly if airway is compromised		* A plan (and backup plan) for securing the airway should be discussed with surgeon prior to induction, particularly if airway is compromised

Barrett.Larson at 21:24, 12 July 2021

2021-07-12T21:24:52Z

← Older revision		Revision as of 14:24, 12 July 2021
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	\|-		\|-
	\|Respiratory		\|Respiratory
	\|		\|High incidence of COPD and decreased respiratory reserve.
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
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	* Glycopyrolate to dray the airway		* Glycopyrolate to dray the airway
			* Albuterol if wheezing noted pre-operatively
			* Patients with significant respiratory disease may need specialized ventilation techniques, such as jet ventilation, apnea intermittent ventilation, high-flow nasal cannula
			* A plan (and backup plan) for securing the airway should be discussed with surgeon prior to induction, particularly if airway is compromised

	=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===		=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
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	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===

			*
	* If doing a GA, can use ETT or LMA		* If doing a GA, can use ETT or LMA
	** Need large ETT (8.0 or greater) to accommodate bronchoscope		** Need large ETT (8.0 or greater) to accommodate bronchoscope
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	\|+		\|+
	!		!
	!~~Variant 1~~		!Flexible bronchoscopy
	!~~Variant 2~~		!Rigid bronchoscopy
	\|-		\|-
	\|Unique considerations		\|Unique considerations
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	\|-		\|-
	\|Position		\|Position
	\|		\|Supine
	\|		\|Supine
	\|-		\|-
	\|Surgical time		\|Surgical time
	\|		\|10-30 mins
	\|		\|10-30 mins
	\|-		\|-
	\|EBL		\|EBL
	\|		\|Minimal
	\|		\|Minimal
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition
	\|		\|PACU
	\|		\|PACU
	\|-
	~~\|Pain management~~
	\|
	\|
	\|-		\|-
	\|Potential complications		\|Potential complications

Barrett.Larson at 21:18, 12 July 2021

2021-07-12T21:18:53Z

← Older revision		Revision as of 14:18, 12 July 2021
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	=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===		=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===

			* Have bronchoscopy swivel adapter (allows bronchoscope to be inserted through ETT/LMA)

	=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===		=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===

			* Glycopyrolate to dray the airway

	=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===		=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
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	=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===		=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===

			* If doing a GA, can use ETT or LMA
			** Need large ETT (8.0 or greater) to accommodate bronchoscope
			** Succinylcholine or intermediate acting NDMR
			** LTA lidocaine
			* If doing a MAC, have supplies ready to secure aware if needed

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===

			* Supine

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

			* Consider TIVA with propofol/remifentanyl
			** Avoid inhalation agents given the potential for large leaks
			* Minimal use of narcotics given brevity of case
			* Decadron

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
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	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

			* Bleeding from biopsy sites
			* Laryngospasm
			* Breathing difficulties
			* Sore throat

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==

Barrett.Larson at 21:07, 12 July 2021

2021-07-12T21:07:33Z

← Older revision		Revision as of 14:07, 12 July 2021
Line 1:		Line 1:
	{{Infobox surgical procedure		{{Infobox surgical procedure
	\| anesthesia_type =		\| anesthesia_type = GA vs. MAC
	\| airway =		\| airway = ETT (use > 8.0 tube) / LMA
	\| lines_access =		\| lines_access = PIV x 1
	\| monitors =		\| monitors = Standard
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative =