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• W2520707732 abstract "The flexible fiberoptic bronchoscope has been a significant advance in bronchoscopic instrumentation. The fiberoptic bronchoscope is a diagnostic and therapeutic instrument, the proper use of which requires an integrated body of knowledge. Bronchoscopy should be considered as only one facet of the pulmonary consultation, which should be complete and thorough. Therefore, training in fiberoptic bronchoscopy should be part of a general subspecialty training program, such as pulmonary medicine, thoracic surgery, or otolaryngology. Obviously, the optimal number of procedures is highly variable and depends on technical skills as well as scientific knowledge. The minimum number of procedures to allow one to be able to anticipate problems and complications is 50 diagnostic bronchoscopies performed under supervision during the training program. The trainee should maintain his competency by performance of bronchoscopy as a part of the pulmonary consultation, when indicated, after the training period. Given the appropriate equipment, facilities, and resources to train a practicing physician, the program should operate so that at the completion of training the physician will be able to describe the uses, limitations, and complications of the procedure. At the completion of training, the practicing physician in training will be able to: 1.Describe normal bronchial anatomy.2.Identify indications and contraindications for bronchoscopy.3.Determine when rigid or flexible instruments should be used.4.Identify and state the purpose of each tool (ie, specimen collector), its capabilities, and when each should be used.5.Anticipate possible complications of flexible bronchoscopy and conditions associated with each complication.6.Select appropriate anesthetic agents, as well as drugs, to prevent procedural complications.7.List prebronchoscopic screening procedures and identify the rationale for use of each.8.Prepare protocols for the sterilization of instruments, including screening for contamination.9.Identify special problems when bronchoscopy is performed on critically ill patients. The physician completing training will be able to: 1.Select the appropriate premedication and write pre- and post-bronchoscopy orders.2.Describe the bronchoscopic procedure in lay terms.3.Intubate (endotracheal) using the flexible bronchoscope.4.Maintain a patent adequate airway at all times.5.Introduce a flexible bronchoscope via the following routes: transnasal, transoral, and tracheostomy.6.Complete an endoscopic inspection of the entire tracheobronchial tree and direct the tip of the bronchoscope into any given segment of the tracheobronchial tree.7.Carry out the following diagnostic techniques: bronchial brushing, forceps biopsy including transbronchial lung biopsy, and segmental bronchoalveolar lavage.8.Manage complications as they arise.9.Properly clean and maintain bronchoscopic equipment." @default.
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• W2520707732 date "1982-06-01" @default.
• W2520707732 modified "2023-10-17" @default.
• W2520707732 title "Guidelines for Competency and Training in Fiberoptic Bronchoscopy" @default.
• W2520707732 doi "https://doi.org/10.1016/s0012-3692(16)57762-9" @default.
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