It has been widely known since the first cases were reported that the novel coronavirus may be transmitted via respiratory droplets produced when an infected person coughs or sneezes.

But, on March 29, 2020, the World Health Organization published a brief that highlighted the many ways a healthcare professional may contract the COVID-19 disease via airborne transmission.

Airborne transmission refers to the presence of disease microbes that can remain in the air for long periods of time and be transmitted to others, even at distances greater than a meter (a little more than 3 feet) in length.  For COVID-19 patients, these microbes may be produced during procedures that generate aerosols, according to WHO.

WHO names several procedures or support treatments in which airborne transmission may be a risk for healthcare professionals, including bronchoscopy.

The following instructional video offers a detailed explanation and demonstration on how to use the Ambu aScope 4 Broncho and the closed-loop sampling solution, the Ambu BronchoSampler, to reduce risk of infection during bronchoscopy.

SOP for bronchoscopy using Ambu aScope 4 Broncho and BronchoSampler during COVID-19 from Ambu A/S on Vimeo.

Extra precautions are also required when performing any of the following procedures on COVID-19 positive patients:

  • Endotracheal intubation
  • Open suctioning
  • Administration of nebulized treatment
  • Manual ventilation before intubation
  • Turning patient to the prone position
  • Disconnecting the patient from ventilator
  • Non-invasive positive-pressure ventilation
  • Tracheostomy
  • Cardiopulmonary resuscitation

The American Association for Bronchology and Interventional Pulmonology (AABIP) released guidelines in March for treating and testing potential or confirmed COVID-19 cases. The AABIP has recommended bronchoalveolar lavage (BAL) not be used as a method of sampling during this time of the pandemic.

In addition, the AABIP also has noted that if bronchoscopy is warranted when treating a potential or confirmed case of COVID-19, a disposable bronchoscope should be used.

The first COVID-19 cases were reported in Wuhan, China in December 2019. WHO declared the disease a global pandemic on March 11, 2020.