Airway management gets dangerous.
In this episode of the podcast, we explore prehospital bronchoscopy—a true bleeding-edge concept—and where it fits in managing airway obstruction before the hospital. We talk mucous plugs, massive hemoptysis, refractory hypoxia, how to address obstructions you can’t fix with pressure or bronchodilators, and what to do when bronchoscopy is likely unavailable. This isn’t about chasing new tools—it’s about physiology, pattern recognition, and knowing when innovation may help.
When it comes to considering prehospital bronchoscopy in your system, ask yourself the following:
- Is this something we need?
- Can we do the training to support it?
Bronchoscopy
Popcorn
Du Rand IA, Blaikley J, Booton R, et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults. Thorax. 2013;68(Suppl 1):i1–i44.
Ernst A, Herth FJF. Principles and Practice of Interventional Pulmonology. New York, NY: Springer; 2013.
Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel’s Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016.
Jolliet P, Chevrolet JC. Bronchoscopy in the intensive care unit. Intensive Care Med. 1992;18(3):160–169.
Papazian L, Colt HG, Scemama F, et al. Bronchoscopy in mechanically ventilated patients. Crit Care. 2002;6(6):518–523.
Facciolongo N, Patelli M, Gasparini S, et al. Incidence of complications in bronchoscopy. Chest. 2009;135(3):781–789.
Restrepo RD, Walsh BK, American Association for Respiratory Care. AARC clinical practice guideline: airway suctioning of the patient in the intensive care unit. Respir Care. 2013;58(3):524–536.
Galvagno SM Jr, Thomas S, Stephens C, et al. Advanced airway management in critical care transport. Air Med J. 2012;31(4):191–201.
