| 1 |
Implement a screening process before the procedure (ask to patients about contacts and symptoms, test for SARS-CoV-2) |
| 2 |
Always use personal protective equipment (PPE), including FFP3, gown, gloves and shield |
| 3 |
Wash hands frequently with soap and water or alcohol-based solutions |
| 4 |
Use disposable bronchoscopes when available |
| 5 |
High-level disinfection procedures for re-usable bronchoscopes |
| 6 |
Standard disinfection protocols for re-usable video monitors and other equipment |
| 7 |
Perform procedures in negative pressure rooms, if available |
| 8 |
Limit the number of staff participating |
| 9 |
Minimize cough with adequate sedation |
| 10 |
Use barriers between the patient and the operator |
| 11 |
Avoid devices that produce aerosols and the use of atomized lidocaine |
| 12 |
Prefer the nasal access for the bronchoscope |
| 13 |
Limit rigid bronchoscopy; if necessary, perform it without jet ventilation |
| 14 |
Perform bronchoscopy with urgent-emergent indications (massive hemoptysis, severe airway stenosis, malignant conditions with endobronchial obstruction and serious symptom) and for other undelayable indications (infectious disease, mild or moderate hemoptysis, suspect of lung or bronchial cancer) |
| 15 |
In the management of lung cancer: |
| • For stage I and II, surgical resection should be considered without tissue diagnosis |
| • For stage III with single station N2 disease, lymphonodal staging with EBUS-TBNA and/or EUS-B FNA is recommended except for patients with bulky/multi-station mediastinal involvement on PET |
| • Percutaneous biopsy, where technically possible, are preferable rather than bronchoscopic approach |
| 16 |
Consider to postpone or avoid bronchoscopy in mediastinal adenopathy suspect for sarcoidosis, interstitial lung diseases, cough and chronic infections |
| 17 |
Consider to postpone or avoid Bronchial Thermoplasty or Bronchoscopic Lung Volume Reduction |
