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Table 1: CoBaTriCE respiratory domain bronchoscopy competence description, including knowledge, skills and behaviours and attitudes.1 |
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Performs fibreopric bronchoscopy and bal in the intubated patient under supervision |
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Knowledge |
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Signs, symptoms and causes of acute airway insufficiency and indications for intervention Principles of emergency airway management Anatomy and bronchoscopic appearance of the upper and lower airways Patient selection-indications, contraindications and potential complications of the procedure/intervention Appropriate use of drugs to facilitate airway control Principles of aseptic technique and aseptic handling of invasive medical devices Universal precautions and preventative infection control techniques (hand washing, gloves, protective clothing, sharps disposal etc.) Complications of the technique, how to prevent/recognise them and initiate appropriate treatment Detection of potential physiological alterations during the procedure Indications for specific monitoring to ensure patient safety during an intervention/procedure Methods of bronchoscopy via an endotracheal tube Methods of bronchoscopic broncho-alveolar lavage (BAL) in an intubated patient Detection and management of haemo/pneumothorax (simple and tension) Safety and maintenance of flexible fibreoptic endoscopes |
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Skills & behaviours |
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Seek appropriate supervision-discuss the patient and procedure with supervisor prior to undertaking it Identify relevant anatomical landmarks Prepare equipment, patient and staff prior to undertaking the procedure Choose an appropriate route/method of insertion and position the patient accordingly Obtain informed consent/assent from the patient where appropriate Undertake bronchoscopy to assess tube position Undertake bronchoscopy to perform bronchoalveolar lavage Performs the procedure in an aseptic manner (scrubs, gowns, gloves, drapes & sterile field) Perform the procedure in a manner which minimises the risks of complications Sterilise, clean or dispose of equipment appropriately Recognise and manage emergencies; seek assistance appropriately |
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Attitudes |
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Recognises personal limitations, seeks and accepts assistance or supervision (knows how, when and who to ask) Considers patient comfort during procedures/investigations Desire to minimise patient distress Accepts personal responsibility for the prevention of cross infection and self infection Lead, delegate and supervise others appropriately according to experience and role Supports other staff in the correct use of devices Promotes respect for patient privacy, dignity and confidentiality |