Bronchoscopy precautions and recommendations in the COVID-19 pandemic.
Paediatr Respir Rev
; 37: 68-73, 2021 Mar.
Article
in English
| MEDLINE | ID: covidwho-1051915
ABSTRACT
As the airways of SARS-CoV-2 infected patients contain a high viral load, bronchoscopy is associated with increased risk of patient to health care worker transmission due to aerosolised viral particles and contamination of surfaces during bronchoscopy. Bronchoscopy is not appropriate for diagnosing SARS-CoV-2 infection and, as an aerosol generating procedure involving a significant risk of transmission, has a very limited role in the management of SARS-CoV-2 infected patients including children. During the SARS-CoV-2 pandemic rigid bronchoscopy should be avoided due to the increased risk of droplet spread. Flexible bronchoscopy should be performed first in SARS-CoV-2 positive individuals or in unknown cases, to determine if rigid bronchoscopy is indicated. When available single-use flexible bronchoscopes may be considered for use; devices are available with a range of diameters, and improved image quality and degrees of angulation. When rigid bronchoscopy is necessary, jet ventilation must be avoided and conventional ventilation be used to reduce the risk of aerosolisation. Adequate personal protection equipment is key, as is training of health care workers in correct donning and doffing. Modified full face masks are a practical and safe alternative to filtering facepieces for use in bronchoscopy. When anaesthetic and infection prevention control protocols are strictly adhered to, bronchoscopy can be performed in SARS-CoV-2 positive children.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Bronchoscopy
/
Infection Control
/
Health Personnel
/
Practice Guidelines as Topic
/
Disease Transmission, Infectious
/
Personal Protective Equipment
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Paediatr Respir Rev
Journal subject:
Pediatrics
Year:
2021
Document Type:
Article
Affiliation country:
J.prrv.2021.01.001
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