A Role for the Respiratory Therapist in Flexible Fiberoptic Bronchoscopy

All bronchoscopies in our institution are performed by physician-respiratory therapist teams. The therapist instructs the patient, anesthetizes him, does the biopsies, and prepares specimens for laboratory testing. Methods: We undertook a retrospective study of our performance to evaluate the safety, yield, and cost of this system. Results: Of 216 procedures evaluated, therapist-performed biopsies provided a specific diagnosis in 55%. When a tumor-like mass was seen directly, biopsies were positive 95.7% of the time. No procedure was associated with death. Complications included fever in about 9%, hoarseness in 2%, hemoptysis in 1%, and pneumothorax in one procedure (0.5%). Our institutional costs for flexible fiberoptic bronchoscopy by a physician-respiratory therapist team were only 34% of what they would have been if the same procedures had been performed in the operating room. Results performed were comparable to all others reported in the literature. Conclusion: This study clearly demonstrates that respiratory therapists can provide high quality, low cost, safe bronchoscopic assistance to pulmonary internists.