Category Archives: Pulmonary Function

Fluoroscopy Availability of a fluoroscopy facility dedicated to bronchoscopy was reported by 20.9 percent (182) of the 871 respondents; the facility was shared with nonbronchoscopists by 74.1 percent (645). No response on this topic was given by 5.1 percent (44). (more…)

Assistance during Bronchoscopy Nurses alone assisted 39.0 percent (340) of the 871 bronchoscopists during the procedure, whereas 26.2 percent (228) physicians utilized nurses and other assistants. Respiratory therapists were the sole assistants to 14.7 percent (128) of the respondents, while 7.6 percent (66) physicians utilized respiratory therapists and others (eg, nurses, laboratory technicians, residents). Assistance was obtained from pulmonary function test technicians and other paramedical personnel by 12.4 percent (108) of bronchoscopists. Phy-sicans were mentioned as bronchoscopy assistants by 15.3 percent (133). (more…)

An informal survey revealed that the former group is more likely to use the rigid bronchoscope, whereas the latter group almost exclusively uses the pediatric FFB. This reflects the traditional use of the rigid instruments by surgeons. Our survey suggests that the adult pulmonary specialist has very little exposure to pediatric bronchoscopy. This may in part be due to the adult pulmonary specialists lack of training in pediatric pulmonology, as well as to the fact that increasing numbers of pediatric pulmonologists are being trained to perform bronchoscopy. (more…)

When asked which specialist performed pediatric bronchoscopy in their clinical setting, the following responses were provided: otolaryngologist, 14.5 percent (126); pediatric pulmonary specialist, 12 percent (105); pediatric surgeon, 3.1 percent (27); thoracic or general surgeon, 2.0 percent (17); and pulmonary specialist, 1.0 percent (9). Interestingly, 62.1 percent (541) did not provide any response to this question, whereas 2.9 percent (25) indicated that the pediatric patients were referred elsewhere, and 1.3 percent (11) answered that they did not know. (more…)

Fifty-eight percent (505) of the respondents mentioned that they had been in bronchoscopy practice for more than ten years. Almost one fourth (214) had been performing bronchoscopy for seven to ten years; 23.5 percent (205), for four to seven years; 9.2 percent (80), for two to four years; and 0.7 percent (6), for less than two years. Seven respondents provided no information on this subject. (more…)

Nearly half (430) were in group practice, 24.9 percent (217) were in solo private practice, 20.8 percent were in academic institutions, and 3.0 percent (26) were in other types of practices (health maintenance organization, 12; armed forces, 8; Veterans Administration, 6; the type of practice was not specified by 17. The respondents' geographic locations in the United States were as follows: Northeast, 27.7 percent (241); Southeast, 17.0 percent (148); North Central, 16.6 percent (145); West, 11.4 percent (99); Southwest, 9.6 percent (84); South Central, 7.2 percent (63); Northwest, 4.1 percent (36); Puerto Rico, 0.2 percent (2). Canadian bronchoscopists accounted for 5.7 percent (50) of the respondents. (more…)

In some cases, we have provided brief comments without addressing the significance of the results, because the accompanying commentary (see page 1660) has dealt with the possible clinical implications of the study. Our comments regarding the findings do not represent the official position of the ACCP Results and Comments Demographics The survey questionnaires were totally or partially completed and returned by 51.2 percent (871) of the 1,700 ACCP members sampled. When a question or a part of it elicited no response from a participant, the lack of response was accepted as neither an affirmative nor a negative response; instead, we reported it as “no response.” (more…)

Methods A questionnaire with 39 questions was developed to include most of the procedures and techniques used in the practice of bronchoscopy. While the questions did not follow an identical format, several common definitions were provided for the survey participants. If a bronchoscopy-related procedure was performed “routinely,” it meant that the responder performed it in more than 85 percent of the time in her/his bronchoscopy practice. If it was performed “sometimes” it meant that the physician used it 6 percent to 84 percent of the time. A “rarely” performed procedure was defined as one used 5 percent or less of the time. Space was provided to write comments on each of the individual questions. At the end of the questionnaire, the respondents were asked to write other comments regarding the practice of bronchoscopy and the questionnaire itself. (more…)

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. (more…)