Starting and managing a bronchoscopy unit

INTRODUCTION Pulmonary endoscopy has evolved tremendously in the past decade. Thanks to new technology, the trained pulmonologist can now perform a large array of diagnostic and therapeutic interventions. The complexity of these procedures demands training, however, and standards should be met before performing them. In addition, it is clear that the success in these procedures depends only partly on the skills of the physician; the skills of the support staff and the adequacy of the facilities and related resources are also indispensable. Increasingly, agencies such as, for example, Departments of Public Health have released regulations affecting work and workflow in endoscopy units in general. Although pulmonologists are frequently in charge of bronchoscopy units, they are generally not prepared during a fellowship to manage these units. In fact, starting or directing a bronchoscopy unit requires substantial knowledge of the necessary staff, equipment, training, procedure space, and applicable regulations and legislation. To help provide this knowledge, I briefly describe these requirements here and comment on their importance in ensuring the success of bronchoscopic services. THE INTAKE AND RECOVERY AREA A dedicated intake and recovery area should be available where nurses can receive and prepare patients for procedures and to help them recover after procedures (Figures 7.1 and 7.2). Here, patients will have their medical records updated and their medications checked to be sure the procedure can be performed safely. Each patient should have his or her own space in the intake and recovery area, with curtains to provide privacy.