Ch 12 Blk Book...Bronchoscopy
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34 terms
Terms | Definitions |
|---|---|
 2 types of bronchoscopes | rigid and flexible |
| Advantage of flexible bronch... | allows for more complete eval of aw |
| Patient preperation for bronch | Pre-eval(cxr, pft, physical exam), Pre-medicate |
| Medications for procedure | Benzodiazepine(VERSED< VALIUM), Local anethesia of upper aw(can spray, lavage or nebulize LIDOCAINE, anticholinergic(ATROPINE, to decrease vagul response (bradycardia) AND dry secretions) |
| Insertion of bronch | ET tube, Trach/stoma, Nose(preferred), Mouth |
| Bronchoscopy | procedure in which there is a systematic eval of AW |
| Specimen sampling | Biopsy, Needle aspiration, Secretions(sample), BAL(used when biopsy/brush are not recommended because of bleeding. |
| Amount of saline for BAL | 100-150 ml, (10-50 ml at a time)..yeah..seems like a lot |
| Indications for diagnostic ( DX) bronch | #1 evaluate lung mass or nodule..2..Chronic cough 3..Eval of hemoptysis(scant or massive, >200 ml in 24 hrs), 4.Pulmonary infections 5.Lung cancer(staging and dx), 6 Suspected foreign body..7 AW burns 8 Vocal Cord Paralysis |
| Diagnostic bronch | to diagnose DX |
| Therapeutic bronch | to treat TX |
| Debulking | TX..rigid bronch, used to break through tumor, mass |
| Balloon dilation | TX..balloon that opens AW..used to insert a stent |
| Endobronchial Laser Therapy | TX..cutting out with laser |
| Cryotherapy | TX..freezing off, liquid nitrogen |
| Brachytherapy | TX..radiation, they inplant little beads(radioactive), into AW..tumor..for radiation |
| Stenting | TX..wire mesh, to hole AW open |
| Indications for therapeutic bronch(tx) | Aspiration of secretions, tx of aw obstruction, control hemoptysis, removal of foreign bodies, closure of bronchial fistulae |
| How to control hemoptysis | Iced salin and epinephrine(to vasoconstrict) less blood flow, less bleeding |
| Patient monitoring during bronch | anethesia related problems(resp depression, hypotension, hypoventilation), Oxygen problems and Hemodynamic problems |
| FiO2 during bronch | Vent(need a bodai adaptor) 100% if on vent...also need to increase high pressure alarm/// |
| Complications of bronch | Anethesia related..Infection..AW obstruction, Pneumo, Hemo, Bronchospasm/laryngospasm |
| Inadequate topical anesthesisa causes | coughing, gaggin, increasing risk of injury...Risk of aspiration after procedure...need to sit patient upright and don't let them eat until they can swallow. |
| Contraindications of bronch | Refractory hypoxemia, cardiovascular instability, bleeding disorders |
| Used to disinfect bronchoscope | CIDEX...(CRT Question) |
| Rigid Bronchs used for... | To burrow thru a larger tumor, or mass, AKA...DEBULKING |
| Therapies allowed by RIGID bronch | Laser, stents, balloon dilation, electrocautery, argon beam coagulation and cryotherapy |
| Flexible Bronch Working channel | used for aspiration of secretions, biopsy forceps, biopsy needles, bronch brushes catheters and ballons |
| Bronch channels | Light source, visualizing, multi purpose open channel(working channel) |
| Bronchial Alveolar Lavage (BAL) | wedging the tip of flex bronch in segmental bronch....normal saline instilled through the bronch channel and sx back into container for anaylsis |
| Chronic Cough | most common reason for patients to seek medical attention |
| short acting benzodiazepine | Versed, Valium, Medazolam |
| anticholinergic | atropine or glycopyrrolate |
| local anethesia | Lidocaine...instilled or nebulized |
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