Bronchoscopy Checklist Generator

Procedure Date:

Time:

Operator:

Assistant:

Supervisor:

Patient identity checked?

Yes

Appropriate consent completed?

Yes

Is Equipment available for bronchoscopy and re-intubation?

Yes

Intubation grade known?

Yes

Should the procedure be delayed for medical optimisation? Consider stability, ventilator pressures, FiO2, anatomical issues

Yes No

Is there coagulopathy? (drugs and lab tests)

Yes No

Known drug allergies?

Yes No

Has enteral feed been stopped and NG tube aspirated?

Yes No

Is patient on adequate ventilator settings and 100% FiO2

Yes

Is patient adequately sedated and paralysed

Yes

Ventilator settings reviewed post procedure?

Yes

Is a CXR required?

Yes No

Sedation plan post procedure

Yes

Samples taken and plan for labelling/lab delivery?

Yes Yes

Any findings that require follow up?

Yes N/A

Bronchoscopy Checklist + Clinical Note Generator