Scheduling+Bronchoscopies

How to Schedule a Non-Urgent Bronchoscopy:

MAIN POINTS: nursing resources have become increasingly limited (we have resource nurses available only from 9-11 AM except for emergencies) so it's important to be aware of how to get the bronchs done and to let us know as soon as possible (the day before is most preferable).

1. Request bronchoscopy consult with Drs. Applegate (pgr 375), Kuruvilla (pgr 598), or Tzvieli (pgr 321). The earlier we know of a possible bronch (especially for inpatients), the better our ability to get it done in a timely fashion.

2. Call Nursing Supervisor, pgr 243, to coordinate the scheduling: a. Please provide nursing supervisor with patient’s name, DOB, MR number, Room number (if inpatient), and verified phone number b. Outpatient: i. Nursing supervisor to put bronch order in Meditech, notify resource nurse, call patient with date/time of procedure and instructions below. ii. If Nursing Supervisor is unable to order bronch, please call the ICU directly at 370-5660 and ask clerk to put bronch order in Meditech and to notify resource nurse. Nursing supervisor is still responsible for contacting patient with the date/time or procedure and instructions. iii. Requesting provider to complete pre-sedation H&P c. Inpatient: i. MD to contact Nursing Supervisor and ascertain bronch date/time ii. MD to write orders in chart for NPO and bronchoscopy iii. Nursing Supervisor to coordinate resource nurse/RT d. Nursing/RT/MD to try to schedule at 9 AM to facilitate use of resource nurse e. Order BUN/Cr, CBC, PT/INR (INR should be <1.3 for biopsy) within 24 hours of anticipated bronchoscopy if these have not been recently drawn

3. Instructions to Patients: a. NPO after midnight (order NPO if inpatient and give IV fluids as needed) b. No aspirin use 1 week prior to bronch (if possible) c. Advise against ibuprofen/NSAID use for 3 days prior to bronch d. Outpatients MUST be accompanied by another person (for driving purposes). They should arrive at least 90 minutes prior to procedure (i.e. 7:30 AM), go through registration (1st floor hospital), and then proceed to 3D ICU (or wherever bronch will take place)

4. On day of bronch, MD, resource nurse, RT, and nursing supervisor must all be aware of procedure (already a given for outpatients, but important for residents to know for their inpatients)

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