Bendigo Health ICU Manual
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        • Beta-blockers
        • Neuromuscular Blocking Agents
        • Aperients / Laxatives
        • Prokinetics
    • Care bundle >
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Care of the Post-Operative Patient
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols + Guidelines >
      • Approach to patient with suspected influenza
      • RAPID INFLUENZA AND RSV TESTING
      • Stroke Protocol (SCV Oct 2018)
    • NIV >
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
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      • The Dying Patient
      • Care of the Dying Patient
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            • Deteriorating patient workshop
            • Ambu Bronchoscope and Cook Surgical Airway CPD workshop
            • Crucial Conversation workshop
            • Team Skills simulation day
            • ALS Simulation
            • Level 1 ECHO training
            • External Speakers
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          • Expectations for all ICU Registrars
          • Expectations for HMOs
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        • Curated educational videos & websites >
          • Virtual bronchoscopy
        • Mandatory training for medical staff
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    • Introduction
    • GO NOW Criteria
    • Admission criteria for paediatric HDU/ICU
    • Commonly used SCV Paediatric Guidelines >
      • Asthma
      • Bronchiolitis >
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis >
        • Algorithm for the management of DKA (to be read in conjunction with SCV guideline)
        • SCV - Diabetic ketoacidosis
      • Seizures >
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child >
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
      • Dehydration >
        • Dehydration
        • IV fluid management
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      • Adult ALS algorithm
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    • Emergency algorithms/mnemonics >
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      • Breathing
      • Circulation
      • Disability
    • MET calls: common scenarios >
      • Staff concern
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Interface with other disciplines
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card
J Yeung: 7/11/17

Bronchoscopy

Picture
For more information refer to the Ambu aScope User Guide  and QuickGuide Bedside Bronchoscopy.
Bendigo ICU has single-use scopes for all bronchoscopy (Ambu®aScope 3).  There are three sizes, Slim (3.8/1.2), Regular (5.0/2.2) and Large (5.8/2.8). (External diameter (mm)/Channel width (mm)).  The monitor has an internal battery with minimum ​3 hour continuous running time when fully charged.
Uses: 
Picture
How to use - quick tips:
  • Connect blue arrow on scope to blue port on monitor.
  • Turn on – hold on/off button on top right of monitor for one second.  The device will be ready for use in around one minute.
  • Turn off – hold on/off button for two seconds.
  • White-balance is not required.
  • When using lubricant, use gauze to smear along the length of scope, to prevent smearing on the camera.  It should not fog due to the heat of the lamp.
Recording images:
Tip: Take a still photo of the patient’s BRADMA label either before or after bronchoscopy for easier identification of the images.
​Still photos:
  • Press camera icon on the screen – icon will turn red then returns to blue
  • Still images can be taken whilst video is being recorded.

Video:
  • Press the video camera icon on the screen – icon turns red on recording, press again to stop recording and icon returns to blue
  • Do not double click on the screen image whilst recording (‘Image extend’), as this will terminate the recording and commence a new one.
Viewing images:
  • Yellow tab for file management
  • Saved under ‘All Users’ – a new folder is automatically created when device turned on and all images will be saved to that folder.
  • Folders and files are named and ordered by numbers in chronological order
  • Images can be transferred to a USB.
Cleaning the monitor:
  • Use V-wipes to clean the monitor and cords. 
  • To prevent moisture entering the monitor ports, ensure that the wipe is not too wet and use a dry cloth/towel to remove any excessive moisture after wiping.
Where to find the equipment in ICU:
  • The monitor is found in the General Equipment store beside the transport monitors.
  • The scopes are in the respiratory equipment store along the corridor with the consultant offices.
Other useful resources:
  • Bronchoscopy simulation – excellent video showing branches of the bronchial tree, good for familiarising with orientation (http://pie.med.utoronto.ca/VB/VB_content/assets/applications/index.html)
  • Bronchoscopy courses
    • The Alfred ICU bronchoscopy course (https://www.alfredicu.org.au/special-interest-groups/bronchoscopy/)
    • CSDS Introduction to flexible Bronchoscopy for respiratory, cardiothoracic and ICU registrars (https://csds.qld.edu.au/sdc/courses/324)
  • Life in the Fast Lane – useful information on bronchial anatomy and flexible bronchoscopy
  • Bendigo Health PROMPT document (intranet only)
  • Home
  • Administration
    • Team members
    • Useful contacts
    • Orientation & Guides
    • Roster rules for ICU junior doctors (Appendix A)
    • App user tips >
      • FindMyShift
      • Kronos
      • Synapse
      • Offsite access to additional email addresses
    • VHIMS >
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • BASIC equipment loan
    • Medical Students in ICU
    • ICU Consultants Only >
      • Echuca Telehealth Consults
      • Shift swap form for consultants
      • Electronic TiL request form
      • CME Claim Process
    • ERH VITCCU
  • Clinical
    • Interface with ED & home teams >
      • ED
      • Surgical teams
      • Cardiology
      • Paediatrics
    • Admissions & Discharges >
      • Admissions & Discharges
      • Admission guidelines for surgical elective and emergency operations
    • Admission guidelines for surgical elective and emergency operations
    • Daily ICU review & care >
      • FAST HUGS IN BED PLEASE
      • Oxygen prescribing
      • Oxygen - Paediatric considerations
      • Care of the Invasively Ventilated Patient – Adult Patient (PROMPT)
      • Assessing for extubation
      • Nutrition in ICU
      • Thiamine prescribing
      • Patient Diaries
    • Drugs & Infusions >
      • Inpatient prescribing practices
      • Common ICU Drugs
      • Drug Infusions A-Z
      • Drugs by system/action >
        • Antibiotics
        • Diuretics
        • Antithrombotic therapy
        • Analgesics in ICU
        • Antipyretic
        • Anticonvulsants
        • Antiplatelets
        • Antihypertensives
        • Beta-blockers
        • Neuromuscular Blocking Agents
        • Aperients / Laxatives
        • Prokinetics
    • Care bundle >
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Care of the Post-Operative Patient
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols + Guidelines >
      • Approach to patient with suspected influenza
      • RAPID INFLUENZA AND RSV TESTING
      • Stroke Protocol (SCV Oct 2018)
    • NIV >
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • The Dying Person in ICU >
      • The Dying Patient
      • Care of the Dying Patient
      • Organ & Tissue Donation
    • Patient transfers >
      • Emergency calls to the helicopter pad
      • Transferring ICU patients >
        • Intra & Interhospital transfers
        • MRI transfers - special considerations
    • Welfare & other supports for patients and family >
      • Visiting times
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
  • Beyond Clinical
    • Education & Training >
      • Education & Training >
        • Learning and Training in ICU
        • Bendigo Health ICU Medical Education Principles >
          • Departmental overview
          • Medical Stream
          • Medical Weekly Schedule >
            • Wednesdays
            • Airway training (hands-on-real time) in Operating theatre
            • Radiology Conference
            • ‘Labs/lytes’ session or equipment or Journal club
            • Tracheostomy day for doctors
            • Deteriorating patient workshop
            • Ambu Bronchoscope and Cook Surgical Airway CPD workshop
            • Crucial Conversation workshop
            • Team Skills simulation day
            • ALS Simulation
            • Level 1 ECHO training
            • External Speakers
            • VICEN
            • Bendigo ICU Journal club
          • Expectations for Consultants
          • Expectations for all ICU Registrars
          • Expectations for HMOs
          • Medical Student program
          • North West Training Hub
          • ICU Simulation
        • CICM Primary Exam education
        • Curated educational videos & websites >
          • Virtual bronchoscopy
        • Mandatory training for medical staff
      • Term Assessments >
        • Registrar Assessments and In-Training Evaluation Reports (ITERs)
        • Registrar term assessments (consultant access only) >
          • Term Assessment form (consultant access only)
      • Procedures and Skills Competency Assessments >
        • Bendigo Health ICU DOPS
        • CICM CVC WCA
        • CICM Tracheostromy WCA
        • CICM Pleural Drain WCA
        • CICM Ventilation WCA
        • CICM ALS & BLS WCA
        • CICM Communication WCA
        • CICM Brain Death WCA
        • CICM OCA
        • ANZCA DOPS
        • ACEM DOPS
      • Echocardiography in ICU
      • BASIC Provider & Instructor Courses
      • Paediatric BASIC Provider & Instructor Courses
      • Other education opportunities
      • Paediatric crit care education
      • Useful learning links
    • Research & Quality >
      • Research >
        • STARRT AKI
        • SuDDICU
        • PLUS study
        • Recent Publications
    • Well-being >
      • Mentorship
      • Looking after yourself and colleagues
    • Medical Students in ICU
  • Paediatric ICU
    • Introduction
    • GO NOW Criteria
    • Admission criteria for paediatric HDU/ICU
    • Commonly used SCV Paediatric Guidelines >
      • Asthma
      • Bronchiolitis >
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis >
        • Algorithm for the management of DKA (to be read in conjunction with SCV guideline)
        • SCV - Diabetic ketoacidosis
      • Seizures >
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child >
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
      • Dehydration >
        • Dehydration
        • IV fluid management
    • Paediatric Crit Care Education >
      • ED/Paeds education sessions
      • Paediatric equipment 'treasure hunt'
      • Curated paediatric educational videos
      • Other paediatric crit care education opportunities
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms >
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics >
      • Airway
      • Breathing
      • Circulation
      • Disability
    • MET calls: common scenarios >
      • Staff concern
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Interface with other disciplines
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card