Training in Laser Bronchoscopy and Proposals for Credentialling: Problems Encountered During and ArrER Laser Bronchoscopy Courses (Part 4)
They have already exhausted other modalities of treatment and have high-grade obstruction of their central airways. The majority of them do not have a simple polypoid lesion which can be removed with the help of a laser in 30 to 45 minutes of operating time. As a consequence, the beginning laser bronchoscopist is usually confronted with a patient in fairly severe respiratory distress with a large tumor, often with markedly distorted landmarks in the airways. Added to this are the time requirements of other aspects of an individual’s practice, whether it is in the office for scheduled patients or running a busy hospital practice, particularly with critical care responsibilities. Few physicians are in large group practices to allow translocation of these other responsibilities for several hours and on short notice, as patients who require laser bronchoscopy often need this service quickly. buy levaquin online
The data from Table 2 indicate that 67 percent of physicians who attended the laser bronchoscopy courses we conducted utilize rigid bronchoscopes as they perform these procedures, at least with some of their cases, and they do so in operating rooms with general anesthetics. Thus, the majority of physicians who begin laser bronchoscopy after attending such courses are able to overcome whatever resistance may exist to get into operating rooms and obtain support from anesthesiologists for their cases. This indicates that the lasers are likely shared by users other than for just laser bronchoscopy, but there are some physicians who appear to be relegated to performing such cases in special procedure rooms or with local anesthetics. The magnitude of the latter problem may be greater than is apparent from the percentages displayed, because responses were not received from all physicians to whom the questionnaires were mailed.