A designated bronchoscopy room or suite is the preferred location for outpatients or inpatients who are not critically ill. Flexible bronchoscopy should be performed only when the relative benefits outweigh the risks. 7.1 Bronchoscopy should not be performed in patients who have a contraindication listed in Section 5.0 of this Guideline, unless the potential benefit outweighs the risk, as determined by the physician bronchoscopist. Need is determined by the presence of clinical indicators as previously described in Section 4.0, and by the presence of contraindications as described in Section 5.0.
Patient outcome is determined by clinical, physiologic, and pathologic assessment.
Procedural outcome is determined by the accomplishment of the procedural goals as indicated in Section 4.0, and by quality assessment indicators listed in Section l l.0. Institutional policies and personal preferences of the bronchoscopist vary greatly regarding the type and method of premedication for bronchoscopic examination. Administration of these medications by intravenous or intramuscular routes is limited to nurses, physicians, or other trained personnel. Aerosolized or atomized drugs, or drugs instilled through the bronchoscope, may be delivered by the respiratory therapist or other trained assistants. Bronchoscopy assisting should be limited to Level II personnel who possess the skills necessary to determine adverse reactions and to undertake the appropriate remedial action.