Skip to main content
. 2020 Apr 11;25(6):574–577. doi: 10.1111/resp.13824

Table 3.

Summary considerations

Non‐COVID patient COVID patient (known or suspected)
Triage
Acuity or indications Postpone elective See footnote
Screening Symptoms§, sick contacts§, pre‐procedure vitals Not applicable
Procedure
Ideal setting Negative pressure room Negative pressure room
Staff Limit personnel Essential personnel only
Mask for patient Slotted mask if transnasal or transoral approach without advanced airway Yes (if not intubated)
PPE
Mask

N95 or FFP3 if significant community prevalence

Consider daily re‐used N95 or FFP3 if low supply

PAPR (superior protection), N95 or FFP3
Eyes Eye protection; full face shield if re‐using N95/FFP3 Full face shield
Other Gown, gloves, cap Gown, gloves, cap
Anaesthesia

Avoid atomized or nebulized lidocaine

Sedation to minimize cough

Consider paralysis to minimize cough in general anaesthesia

Avoid atomized or nebulized lidocaine

Sedation to minimize cough

Consider paralysis to minimize cough in general anaesthesia

Equipment No consensus/recommendations Disposable if available
Approach Avoid rigid bronchoscopy Avoid rigid bronchoscopy; minimize flexible scope in/out
Ventilation Closed‐circuit ventilation if advanced airway; avoid jet Closed‐circuit ventilation if advanced airway; avoid jet
Post‐procedure
Scope disinfection No consensus/recommendations Standard high level
Room disinfection No consensus/recommendations

Consider air circulation time per local air controls

Consider sterilizing surfaces

Specific indications considered elective by AABIP: mild airway stenosis, mucus clearance, suspected sarcoidosis without indication for immediate treatment, chronic interstitial lung disease, suspected Mycobacterium avium‐intracellulare, chronic cough, tracheobronchomalacia evaluation, bronchial thermoplasty and bronchoscopic lung volume reduction.

Possible indications: inconclusive non‐invasive COVID‐19 testing2, 3, 4, 5; concern for an alternate aetiology of respiratory disease which would change management2, 3, 4, 5 (especially in immunocompromised4); suspicion of superinfection4, 5; lobar or entire lung atelectasis concerning for mucus plugging,4 facilitate tracheostomy,4 life‐saving or emergent intervention (significant haemoptysis, severe central airway obstruction or stenosis, foreign body).2, 3, 4, 5

§

Consider phone screening 1–2 days in advance.

Unless unavoidable in the clinical circumstance.

AABIP, American Association for Bronchology and Interventional Pulmonology; COVID‐19, coronavirus disease 2019; PAPR, powered air‐purifying respirator; PPE, personal protective equipment.