Bronchoscopy in the emergency department

Area of Science:

• Emergency Medicine
• Pulmonology
• Critical Care

Background:

• Flexible bronchoscopy is a well-established procedure for tracheobronchial tree disorders.
• Emergency physicians possess the skills for flexible bronchoscopy, yet its use beyond endotracheal intubation confirmation is underreported.

Purpose of the Study:

• To detail the indications, outcomes, and complications of flexible bronchoscopy performed by emergency physicians.
• To evaluate the effectiveness and safety of emergency department-performed flexible bronchoscopies.

Main Methods:

• A single-center retrospective cohort study analyzed 146 patients undergoing flexible bronchoscopy in the emergency department.
• Data was collected via chart and video review, including demographics, indications, procedure details, findings, outcomes, and complications.
• Descriptive statistics were used for data analysis.

Main Results:

• Flexible bronchoscopies were performed or supervised by attending emergency physicians in 146 patients.
• 24% of patients showed improved oxygenation or resolved lobar collapse post-procedure; most had no change.
• One patient experienced temporary hypoxemia; subsequent bronchoscopies agreed with ED findings 86% of the time.

Conclusions:

• Emergency physicians can safely and effectively utilize flexible bronchoscopy in the emergency department.
• The procedure aids in the diagnosis and treatment of critically ill patients.
• Findings support the expanded role of emergency physicians in performing flexible bronchoscopies.