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Related Concept Videos

Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Endoscopic Procedures V: ERCP01:26

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Bronchoscopy in the emergency department.

Daniel H Lee1, Brian E Driver2, Matthew E Prekker3

  • 1Department of Emergency Medicine, Kaiser Permanente Medical Center, San Diego, CA, USA.

The American Journal of Emergency Medicine
|June 9, 2022
PubMed
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Emergency physicians can safely perform flexible bronchoscopy for critically ill patients, aiding in diagnosis and treatment. This procedure showed improvement in some patients and had a high agreement rate with subsequent bronchoscopies.

Keywords:
Airway managementEmergency bronchoscopyFlexible bronchoscopy

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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.