A role for the respiratory therapist in flexible fiberoptic bronchoscopy

All bronchoscopies in our institution are performed by physician-respiratory therapist teams. The therapist instructs the patient, anesthetizes him, does the biopsies, and prepares specimens for laboratory testing.

We undertook a retrospective study of our performance to evaluate the safety, yield, and cost of this system.

Of 216 procedures evaluated, therapist-performed biopsies provided a specific diagnosis in 55%. When a tumor-like mass was seen directly, biopsies were positive 95.7% of the time. No procedure was associated with death. Complications included fever in about 9%, hoarseness in 2%, hemoptysis in 1%, and pneumothorax in one procedure (0.5%). Our institutional costs for flexible fiberoptic bronchoscopy by a physician-respiratory therapist team were only 34% of what they would have been if the same procedures had been performed in the operating room. RESULTS performed were comparable to all others reported in the literature.

This study clearly demonstrates that respiratory therapists can provide high quality, low cost, safe bronchoscopic assistance to pulmonary internists.