British Thoracic Society guidelines on diagnostic flexible bronchoscopy.

Introduction These guidelines have been developed at the request of the Standards of Care Committee of the British Thoracic Society (BTS). Two particular problems have emerged since the previous BTS guidelines were published. 2 Firstly, there have been many cases reported recently of atypical mycobacteria causing contamination of bronchoscopes leading to pseudoinfections. Secondly, toxicity from glutaraldehyde has become a significant problem as it has been implicated in cases of occupational asthma among some nursing and technical staV working in endoscopy units (the term “endoscopy unit” is used in these guidelines as most bronchoscopy services are now carried out within such units). The previous BTS bronchoscopy guidelines were brief and were not based on a formal search of published evidence. A Working Group was formed at the request of the BTS with instructions to develop formal evidence-based guidelines for flexible bronchoscopy. The Committee consisted of individuals with a wide range of backgrounds including nurses, a microbiologist, an infection control expert, as well as respiratory physicians including one with a special interest in intensive care medicine. Full details are given in Appendix 1. The aim of the Committee was to produce evidence-based guidelines for subsequent use by medical, nursing, and technical staV. The areas to be covered were carefully defined andwere primarily to advise on bronchoscopy in adults, although the sections of the guidelines concerned with staV safety and instrument decontamination would also be relevant to paediatric flexible bronchoscopy. The areas covered by these guidelines are as follows: