Canadian Health&Care; Mall

The versatility of the flexible fiberoptic bronchoscope (FFB), introduced just over two decades ago, vastly changed the practice of bronchoscopy. Even though broad guidelines for bronchoscopy have been recommended by various organizations, there are no standards established for any of the techniques or procedures for using the bronchoscope. Since these guidelines have been broad and loosely structured, the training of new pulmonary physicians in bronchoscopy has to a large extent depended on their teachers' training in the procedure and on postgraduate courses. This has led to wide variations in the application of bronchoscopy techniques in clinical practice. Several surveys of bronchoscopists have looked into the frequency of complications of FFB use in the United States.^nA postal survey of 231 bronchoscopists in the United Kingdom reported on the prevalence of use of the FFB versus the rigid bronchoscope, use of the nasal versus the oral route of introduction of the FFB, use of sedatives and special procedures, and the incidence of complications. There have been no publications, however, describing the techniques or standards of practice used by bronchoscopists in North America. In an effort to understand the clinical application of bronchoscopy in the United States and Canada, the American College of Chest Physicians (ACCP) conducted a mail survey.