ABSTRACT
Bronchoscopic examination of the pediatric airway may be performed electively for the diagnosis and/or management of airway disease. Anteroposterior and lateral chest radiographs should be performed in the assessment of foreign body inhalation. Radio-opaque foreign bodies may be observed directly. The ventilating bronchoscope and any associated ancillary equipment should be prepared prior to the induction of general anesthesia. A moistened swab may be used to protect the upper alveolar ridge in infants. In older children, a Silastic gum guard may be preferred. Direct laryngoscopy is performed using an appropriately sized open laryngoscope with a lateral slot. The bronchoscope is inserted through the laryngoscope lumen. It is sometimes helpful to unlock the Hopkins rod from the bronchoscope during insertion and withdraw it slightly into the lumen of the bronchoscope. Respiratory distress following rigid bronchoscopy may be helped by dexamethasone and nebulized epinephrine. However, increasing airway obstruction may necessitate intubation.
