Pediatric Bronchoscopy for Clinicians

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This book is a quick reference guide and atlas for performing bronchoscopy in pediatric patients. It offers a multidisciplinary approach, incorporating the perspectives of pediatric pulmonology, otolaryngology, anesthesiology, and respiratory therapy by outlining important anatomic and physiologic considerations. It describes the basic and advanced techniques in performing flexible, rigid, and special bronchoscopy maneuvers and approaches. This book enhances the reader’s understanding of the critical skill of clinical evaluation and management of the pediatric airway. It is addressed to junior and senior trainees as well as early- and late-career clinicians involved in pediatric bronchoscopy as an on-the-go guide.

Key Features

• Pays special attention to including widely applicable techniques that can be employed across a variety of domestic and international practical settings, complete with a wealth of accompanying videos and illustrations from real-world experiences that are easy to replicate and reference in practice.

● Promotes a multidisciplinary approach to the evaluation of the upper and lower airways in children with respiratory and aerodigestive pathology as the lines between pediatric pulmonology, otolaryngology, anesthesiology, surgery, critical care, and emergency medicine are blurring, thus providing wellequipped clinicians with a thorough perspective of all disciplines.

● Features bullet-pointed lists for pre-procedure evaluation, with procedural checklists, images, and videos, and serves as a portable, compact, and accessible quick reference guide.

Author(s): Kara D. Meister, Don Hayes Jr.
Edition: 1
Publisher: CRC Press
Year: 2022

Language: English
Pages: 158
City: Boca Raton

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Preface
Acknowledgments
Editors
Contributors
Chapter 1 Clinical indications for bronchoscopy
Introduction
Advantages of bronchoscopy over clinical assessment and chest radiography
Clinical Applications of Rigid Bronchoscopy
Evaluate airway anatomy
Assess airway dynamics
Obtain clinical samples
Therapeutic intervention
Clinical Applications of Flexible Bronchoscopy
Evaluate airway anatomy
Assess airway dynamics
Obtain clinical samples
Therapeutic intervention
Case Presentation
Conclusion
Tips for Clinical Practice
References
Chapter 2 Basics of flexible bronchoscopy and equipment
Introduction
What is flexible bronchoscopy?
About the instruments: flexible versus rigid bronchoscopes
Flexible bronchoscopes
Advantages of flexible bronchoscopy over rigid bronchoscopy
Advantages of performing a combined airway evaluation
Equipment
The minimum equipment we recommend for a bronchoscopy program
Bronchoscopy supply items
Components of the flexible bronchoscope (Figures 2.4, 2.5, and 2.6)
Basics of handling a flexible bronchoscope
Preparation for a flexible bronchoscopy
What do you need to know before performing a flexible bronchoscopy?
Performing Flexible Bronchoscopy: Steps and Technique
“Driving” (manipulation) of the flexible bronchoscope: Tips17
Obtaining a bronchoalveolar lavage (BAL)3,18–20
Post-bronchoscopy care of the patient17,22–24
Procedure report
Bronchoalveolar lavage specimen processing19
Nosocomial infections and flexible bronchoscopy
Transportation of the flexible bronchoscope
Care of the flexible bronchoscope
Leak test
Cleaning and sterilization3,7,25,26
Storage of the bronchoscope
Team Approach and Building a Bronchoscopy Service17,23
Conclusion
References
Chapter 3 Basics of microlaryngoscopy and rigid bronchoscopy
Introduction
Rigid bronchoscopes
Advantages of rigid bronchoscopy
Preparation
Anesthesia
Room Arrangement
Patient factors
Equipment
Technique
Use of the rigid ventilating bronchoscope
Conclusion
Tips for Clinical Practice
References
Chapter 4 Upper airway bronchoscopic interpretation
Introduction
Nasal cavity
Nasopharynx
Soft palate
Oral Cavity and Oropharynx
Hypopharynx
Epiglottis and supraglottic larynx
Larynx
Subglottis
Proximal Trachea
Conclusion
Tips for clinical practice
References
Chapter 5 Lower airway bronchoscopic interpretation
Introduction
Advantages of flexible bronchoscopy over rigid bronchoscopy for evaluation of the lower airways
Pearls
Normal Lower Airway Anatomy
Trachea
Bronchi
Pearls
Common Lower Airway Abnormalities
Subglottis
Trachea
Pearls
Bronchial tree
Pearls
Conclusion
References
Chapter 6 Upper airway bronchoscopic approach and diagnostic procedures
Introduction
Drug-induced sleep endoscopy (DISE)
Bronchoscope-assisted transnasal intubation
Intubation via a supraglottic airway device
Conclusion
Tips for Clinical Practice
References
Chapter 7 Lower airway bronchoscopic approach and diagnostic procedures
Introduction
Indications for lower airway evaluation
Potential complications
Equipment
General preparation
Positioning
Lower Airway Interventions
Bronchoalveolar lavage (BAL)
Bronchial washing
Bronchoscopic Biopsies
Cytologic bronchial brushing
Endobronchial biopsy
Transbronchial biopsy
Foreign Body Removal
Conclusion
Tips for Clinical Practice
References
Chapter 8 Advanced bronchoscopic procedures
Introduction
Endobronchial Ultrasound with or without Transbronchial Needle Biopsy
Preparation, positioning, and anesthesia
Equipment
Technique
Endobronchial biopsy
Preparation, positioning, and anesthesia
Equipment
Technique
Airway Stenting
Preparation, positioning, and anesthesia
Equipment
Technique
Maintenance
Endobronchial Valves
Equipment
Technique
Endobronchial blocker
Equipment
Technique
Cryotherapy
Equipment
Technique
Laser
Preparation, positioning, and anesthesia
Equipment
Technique
Conclusion
Tips for Clinical Practice
References
Chapter 9 Bronchoscopy for specific situations
Introduction
Foreign body removal
History
Large-volume/massive pulmonary hemorrhage
Initial Management
The Aerodigestive Patient and Combined Endoscopy
Traumatic Aerodigestive Injuries
Tracheopathies
Mucopolysaccharidoses (MPS)
Select Tracheal Cartilage Abnormalities
Whole-lung lavage
Plastic bronchitis
Conclusion and Tips for Clinical Practice
References
Chapter 10 Bronchoscopy training and simulation for medical education
Introduction
Teaching methods
Cognitive phase of pediatric bronchoscopy training
Medical knowledge – Anatomy and physiology of the pediatric airway
Technical, instrumental, and clinical knowledge
Modes of delivering theoretical knowledge
Practical Training for Pediatric Bronchoscopy – Current State of Simulation
Bronchoscopy simulators
Practicing non-technical skills
Practical Training for Pediatric Bronchoscopy – Intra-Operative Teaching
Accreditation: Training requirements and competency assessment tools
Continuous professional development
Future opportunities
Conclusion
Tips for Clinical Education
References
Chapter 11 Airway management and anesthetic considerations
Introduction
Location – bedside/intensive care unit versus operating room/endoscopy suite
Airway Securement
Medications for pediatric bronchoscopy
Complications during Pediatric Bronchoscopy
Conclusion
Tips for Clinical Practice
References
Index