Safe performance of diagnostic bronchoscopy/EBUS during the SARS‐CoV‐2 pandemic

Abstract

The SARS-CoV-2 pandemic is unprecedented in our professional lives and much effort and resources will be devoted to care of patients (and HCW) affected by this illness. We must also continue to aim for the same standard of care for our non-COVID respiratory patients, while minimizing risks of infection transmission to our colleagues. This commentary addresses the key paired issues of minimizing performance of diagnostic/staging bronchoscopy in patients with suspected/known lung cancer while maximizing the safety of the procedure with respect to HCW transmission of COVID-19.

Bronchoscopic procedures during COVID‐19 pandemic: Experiences in Turkey

“…16 The first American Association for Bronchology and Interventional Pulmonology statement was published in late March; in the following days, expert opinions on the use of bronchoscopy during the COVID-19 pandemic were published one after another. [17][18][19][20][21] While the use of PPE and bronchoscopy indications were similar between the published reports and our practice, not using negative pressure rooms, not testing all patients, using a reusable bronchoscope and only giving a 30-minute interval between the procedures are the notable differences between the reports and our practice. We proved that these differences did not cause any problems in the detection of COVID-19 in either patients and health care workers after the procedure.…”

Novel device to prevent droplets in bronchoscopy during the SARS‐CoV‐2 pandemic

“…Therefore, reducing healthcare workers' (HCWs) exposure is important. Bronchoscopy guidelines recommended postponement, but, if essential, HCWs should wear full personal protective equipment (FPPE) 2–4 . Various measures have been reported to prevent splashing via reflex vomiting, sneezing, and coughing during esophagogastroduodenoscopy 5 .…”

“…FB, including oral suction, can be conveniently performed through the central X‐shaped cut of the NWF. Bronchoscopy guidelines suggest oral insertion through a small incision in a standard surgical mask (Fig 1f,i) or nasal insertion 2–4 . However, unlike the NWF, the mask is fixed to the patient's ears, so the incision in the mask and mouthpiece may misalign as patients move or during FB removal/reinsertion.…”

Fiberoptic bronchoscopy via intubation box during COVID‐19 pandemic

“…So nebulized lidocaine administration is not recommended for premedication because it increases the risk of aerolization. 7 We did not use nebulized lidocaine in our clinic. Only intranasal or intraoral lidocaine was applied for topical anesthesia and to minimize cough.…”