Flexible bronchoscopy has become available in the emergency department even though it is primarily used by intensivist and pulmonologist. It is established for remocal of foreign body,toilet bronchoscopy, securing difficult airway and many others. Flexible bronchoscopy allows direct inspection for both upper and lower airway, and facilitates in the diagnosis and management of multiple pulmonary disorders. We highlighted 2 cases presenting to our department where emergency bronchoscopy was done as part of patient management. Both patient was successfully extubated with no adverse effect from the procedure.
We use FUJIFILM Fibrescope FB-120MP, 50 cm flexible fibreoptic bronchoscope to a patient as indicated for therapeutic bronchoscope. Two bronchoscopies performed during the period of observation. The primary objective is to observe complication arises from the procedure. Secondary objective is to look at the outcome of our bronchoscopy.
There were 2 cases included thus far. Both patient was intubated due to acute respiratory distress. There is no complication arises for both cases. Both patient's mechanical ventilation was improved evidence by good ventilation and oxygenation parameters post procedures. 1st patient showed improvement in the chest x-ray post procedure and the 2nd patient shows no improvement in the chest radiograph. However, both patient had shorter ICU stay and days on mechanical ventilation.
Therapeutic bronchoscopy in emergency department is feasible and have significant impact on patient's outcome