Respiratory disease, and treatment / thematic poster session one-person bronchoscopy in COVID-19 patients on mechanical ventilation is safe and decreases exposure rate to hospital personnel

ABSTRACT

Introduction and rationaleMany patients with COVID-19 are admitted to the intensive care units and require bronchoscopy for bilateral pulmonary infiltrates. Historically, the bronchoscopist is accompanied with a technician and a nurse for the procedure. Fear of increasing personnel exposure has been concerning. We present our protocol to prevent exposure during bronchoscopy.Methods:Patients with COVID-19, on mechanical ventilation requiring bronchoscopy were selected between March 2020 and October 2020. Instead of having the whole bronchoscopy team involved, and need for decontamination of equipment post procedure, a disposable bronchoscope was used, and the bronchoscopist was the only person to perform the procedure.Results:A total of 94 bronchoscopies were performed mostly for the evaluation of non-resolving or worsening infiltrates and respiratory failure. All procedures were completed with a single operator in the room, and the use of topical anesthesia through the ETT. The procedure time was less than five minutes, there was no desaturation, no immediate complications, and all procedures were performed with the recommended safety precautions including masks and contact protection garment. Importantly, there was no operator conversion to positive COVID-19 status.Conclusion:we conclude that in patients with Covid-19 receiving mechanical ventilation, oneperson bronchoscopy procedure is highly effective, safe and decreases staff exposure to COVID-19 .