Application of a flexible bronchoscopy program in critically ill patients in the emergency department

Background Flexible bronchoscopy is an excellent and relatively safe diagnostic and therapeutic tool. It is widely performed by non-pulmonologist physicians in controlled areas such as intensive care units. Due to the high volume of workload in emergency departments, flexible bronchoscopy programs are difficult to implement in critically ill patients. Objectives To determine the indications, complications, operational effectiveness, and feasibility of a flexible bronchoscopy program in critically ill patients performed by non-pulmonologist physicians (emergency medicine specialists) in the emergency department of an urban general hospital. Methods This is a retrospective, descriptive cohort study of flexible bronchoscopies performed by emergency medicine specialists over a 2-year period in the emergency department in 53 critically ill patients, both intubated and non-intubated. Demographic data, including age, gender, indications, comorbidities, pre- and post-bronchoscopy hemodynamic and ventilatory parameters, pre and post bronchoscopy chest imaging, and complications were recorded. Results were analyzed using descriptive statistics. Results During the study period, 53 patients underwent flexible bronchoscopy. 64.8% of the patients were intubated and undergoing mechanical ventilation, and 30.2% underwent flexible bronchoscopy while the patient was awake. The main indication for bronchoscopy was severe pneumonia in 43.3% of the patients, followed by hemoptysis in 18.9%. Bronchoalveolar lavage (BAL) was the most frequently performed bronchoscopic procedure (81.1%). Radiological improvement was achieved in 84.9% of patients, with a complication rate of 1.9%. Conclusions The results show that the use of a flexible bronchoscopy program by emergency medicine specialists is effective and safe for the diagnosis and treatment of severe respiratory illnesses in general hospitals.