RT-22 · Initiation & Modification

Bronchoscopy & Special Procedures

Assisting with bronchoscopy, thoracentesis, chest tubes, and arterial lines — the setup, the monitoring, and the complication you must catch.

~16 min read3 concept sections·2 questions with rationale

What you'll be able to do

  • Prepare equipment and monitoring for bronchoscopy
  • Recognize procedural complications early
  • Interpret a three-chamber chest drainage system
  • Support arterial line and sampling safety
Concept breakdown
01

Bronchoscopy

Your job is airway, oxygenation, and monitoring while someone else drives the scope.

  • Indications: retained secretions and lobar atelectasis unresolved by therapy, hemoptysis, foreign body, difficult intubation, tissue sampling, and lavage.
  • Through an endotracheal tube, the tube must be at least 2 mm larger than the scope; the scope can occupy half the lumen and cause auto-PEEP and hypoxemia.
  • Increase FiO2 to 100% before and during, monitor SpO2, ECG, and blood pressure continuously, and keep suction limited to short bursts.
  • Complications: hypoxemia, bronchospasm, bleeding, arrhythmia, laryngospasm, and pneumothorax after transbronchial biopsy — get a post-procedure chest film.
At the bedside

Desaturation during bronchoscopy is usually suction-related. Stop suctioning, raise FiO2, and let the lung recruit before continuing.

Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

A chest tube water-seal chamber bubbles continuously and the patient's subcutaneous emphysema is worsening. The therapist should:

Practice questions

Answer first, then read why the distractors fail.

Question 1

A chest tube water-seal chamber bubbles continuously and the patient's subcutaneous emphysema is worsening. The therapist should:

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2 more concept sections, 1 more question, and the exam-day playbook for this module.

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