A Survey of Bronchoscopy Practice in Australia and New Zealand

The authors assessed the variability of bronchoscopy practice in Australia and New Zealand through survey in the setting of recently published guidelines.

In June 2014, an email survey was sent to every member of The Thoracic Society of Australia and New Zealand who was a doctor.

Responses were received from 258 of 824 doctors. Australia and New Zealand was the location of training for 91% and the United Kingdom for 9%. United Kingdom-trained doctors are more likely to conduct bronchoscopy from the patient's side rather than from behind. The services of anesthetists are utilized by 81% of private bronchoscopists compared with 38% of public ones. Two sedatives are used by 94% of bronchoscopists, 96% of whom use midazolam and fentanyl and 4% use midazolam and propofol. When anesthesia is provided by anesthetists, 77% use 2 agents, of which 53% use midazolam and fentanyl and 37% use midazolam and propofol. Those who work publicly conduct more procedures and are younger. For patients with heart valve defects, 39% prescribe prophylactic antibiotics and 16% do not cease clopidogrel where biopsy is anticipated. In 2013, pneumothoraces complicated 0.22% of procedures, whereas the mortality rate was 0.019%. Almost all monitor oxygen saturation during the procedures.

This survey shows that there is a large variation in bronchoscopy practices both generally and between different groups of bronchoscopists, yet it is a safe procedure. An important finding was the significantly high utilization of the services of anesthetists for sedation and their different sedative choices, including the use of propofol.