We have two 4.9 mm diameter scopes (all that is necessary for percutaneous tracheostomies) and one larger 5.9 mm diameter scope (ideal for diagnostic / therapeutic bronchoscopies).
This scope should be used through a minimum size 7.5 ETT, ideally upsize it pre-procedure if you can. (Note that the larger scope is now obsolete, and should only be used as a last resort. We are hoping to get another small one.)
We also have a small emergency fibroscope, which is kept in the FOB. This requires special cleaning if used, so should only be used if there is nothing else available.
Clean bronchoscopes are kept in the drying cabinet on 4E. If you need a scope, please ask the techs to remove it from the cabinet for you – they will know how to log the scope out of the cabinet and what tracking paperwork needs to be done. It will come in its tray, in a clear plastic bag, on the video stack.
Please only request a scope if you are about to use it, not hours before. It can only remain sterile outside the cabinet for a limited time. Once removed it will have to go to endcoscopy for cleaning, even if it has not been used, thus taking it out of service for several hours.
Please handle the scopes very carefully. Do not force them through a catheter mount into the ETT or provoke a flexion/extension injury! Pay particular attention to the location of the bronchoscope during percutaneous tracheostomies to avoid a needle – stick injury to it. Always pull back well into the ETT before needle puncture.
After use:
- replace the protective waterproof cap securely over the electrical connections
- suck 500 mL of sterile water through the suction channel
- place the scope back into the tray and cover it with the red bag supplied (please ensure the tip of the scope is lying in the little plastic holder, which prevents it poking through the base of the tray)
- fill in the scope cleaning form which will have come with it and attach it to the outside of the bag – THIS MUST BE DONE SO WE CAN TRACE THE SCOPE TO THE PATIENT
- place the scope in its tray in the dirty scopes trolley in the blood gas room; in hours, let the techs know you have finished
- DO NOT RETURN SCOPES TO THE DRYING CABINET (even if not used)
- DO NOT THROW ANY ATTACHMENTS AWAY – if in doubt, leave them in the tray with the scope
We also have disposable Ambu scopes and the mobile screen kept on the difficult airway trolley. These are expensive pieces of kit. Your default should be to use the stack, reserving these scopes for airway emergencies or the rare occasions (e.g. long weekends) when scope decontamination is not available and we are running low on reusable devices.