You need to know some basic information about the actual bronchoscope
- The bronchoscope consists of a handle and fiberoptic bundle. When the
bronchoscope is attached to a light source, the light passes through the fiberoptic bundle
to illuminate the bronchus.
- There is a channel for suction and passage of the instruments.
- The knob of the handle controls the position of the tip of the scope.
- The channel on the side facilitates instillation of anesthetic or saline. The
same port can be used for passage of biopsy forceps. Suction can be obtained by closure of
this port with your finger. You are now ready for the procedure.
Introduction of the Bronchoscope:
- Pass a mouth bite over the bronchoscope and position it close to the handle.
- Lubricate the scope with surgilube, with the exception of the tip. Ask the
patient to protrude his tongue and gently pull it forward with gauze. Introduce the scope
into the pharynx.
- Stay in midline. With gentle movement of the controls, you can bring the
epiglottis into view.
- Instill 2 cc's of 2% xylocaine into the larynx. Observe the vocal cords and note
its mobility with phonation.
- Introduce the scope between the vocal cords into the larynx. Occasionally, it may
be necessary to make the patient pant to facilitate the process. Instill 2 cc's of
xylocaine. Position the mouth bite so that the patient can bite on it. Affix it with tape.
Note that the bronchoscope passes through the mouth bite. The patient cannot accidentally
bite and damage the bronchoscope.