Survey Of Respiratory Endoscopy Practices In Hebei Province

Objective: To investigate the prevalent practices of respiratory bronchoscopy of secondary and tertiary hospitals across Hebei province.To enhance the security and standardization for performing respiratory endoscopy based on medical evidence simultaneously.Methods: An electronic questionnaire was conducted in secondary and tertiary hospitals across Hebei province.The survey questionnaire was structured and divided into various sections that included the general information of hospitals equipped with respiratory endoscopy,personnel who engaged in bronchoscopy,number of annual examinations,equipment availability,respiratory endoscopy techniques,peri-procedural patient management,safety management including patients’ and stuffs’ safety and protection,anesthesia,respiratory endoscope disinfection and training.Results: Questionnaires were received from 179 hospitals,of which 144 secondary hospitals and 35 tertiary hospital were participated.1.General information: In the 179 hospitals participated,99 hospitals were equipped with respiratory endoscope,89 hospitals had respiratory endoscopy suites,86 hospitals had independent respiratory departments and respiratory endoscopy belonged to respiratory departments in 52 hospitals.2.There were more physicians and nurses engaged in respiratory endoscopy in tertiary hospitals than those in secondary hospitals(P<0.05).3.Both the secondary hospitals and the tertiary hospitals mainly performed diagnostic and inpatient respiratory endoscopy.4.There were 66 secondary hospitals(45.83%)and 33 tertiary hospitals(94.29%)equipped with respiratory endoscopy,major of which was fiberoptic bronchoscopy(59.60%)and electronic bronchoscopy(81.82%).5.Conventional bronchoscopy,bronchoscopy alveolar lavage and transbronchial lung biopsy had a higher popularizing rate in respiratory endoscopy.6.Before respiratory endoscopy: The examination rate of chest contrast-enhanced computed tomography and arterial blood gas analysis was lower than others.Except for low molecular weight heparin,anticoagulant and antiplatelet drugs were suspended for 7 days before respiratory endoscopy in most of hospitals.To the patients at risk for asthma attacks,bronchodilator(s)and steroid(s)were administered prior to respiratory endoscopy in 97.65% of all hospitals.Atropine was used before respiratory endoscopy in 15.73% of hospitals.The use of local anesthesia was preferred,followed by intravenous basal anesthesia and general anesthesia.The most preferred method for local anesthesia was2% lignocaine,of which transtracheal lignocaine administration,spraying lignocaine to the pharynx and nebulizing lignocaine were the most used.Midazolam and propofol were the most preferred drug for intravenous sedation.7.Safety measures: Except for visual laryngoscope,defibrillator and tracheal intubation,emergency apparatus was equipped in over 90% of hospitals.More than 76% hospitals were equipped with emergency medication.Approximately 70% of hospitals are equipped with eye protection and examination beds with bed gears.Disposable brushes and biopsy forceps were used in above 95% of all hospitals.Masks and gloves were used in all hospitals.Gowns and eye protection were used in 83.84% and 68.69% of hospitals.8.After respiratory endoscopy: Chest radiograph was taken in46.46% of hospitals after transbronchial lung biopsy.Majority(68.75%)used glutaraldehyde as the disinfectant,and the preferred sterilization method was ethylene oxide and low-temperature plasma.As for storage of respiratory endoscopes,respiratory endoscopes were stored in a hanging position in65.98% of hospitals and 44.33% of hospitals were equipped with drying equipment.9.More than 70% of hospitals regularly carried out respiratory endoscopy related training and seminars.Conclusions: Compared with the secondary hospitals in Hebei province,the tertiary hospitals show more advantages in various types of respiratory endoscopy equipment and techniques.Premedication adjustment,staff protection,respiratory endoscopy storage and other aspects still need to be further standardized,the enhancement of training on respiratory endoscopy is required as well.This survey provided a basis for standardizing the usage of respiratory endoscopy and popularizing related techniques in Hebei Province.