Bronchoscopy

The patient was correctly identified and a time out procedure was performed. He was placed on 100% FiO2. The lubricated bronchoscope was passed through the ETT to visualize the trachea and 4ml of 4% lidocaine was injected through the working port into the airway just at the tip of the ETT. This was followed with air to clear all the lidocaine out of the bronchoscope channel. 

After a minute, we began bronchoscopy through the ETT. The carina was visualized.  The right upper lobe was identified with the anterior/apical/posterior Mercedes-Benz sign. The bronchoscope was then passed into the right middle and lower lobes.

Similarly, the left upper and lower lobes were canulated.

Lavage was performed in all segements and suctioned clear. 

The patient tolerated the procedure well and a Chest XRay is ordered.