Meeting Quality Standards in Endobronchial Ultrasound

Title: Meeting Quality Standards in Endobronchial Ultrasound
Author(s): N Smyth, M Kelly, C King
Institution: Altnagelvin Hospital
Poster: Click to view poster
Category: Lung Cancer and Bronchoscopy
Abstract: Endobronchial ultrasound (EBUS) plays a key role in the diagnosis and staging of suspected lung cancer. We reviewed EBUS data from April-October 2020, comparing results with the British Thoracic Society’s “Quality Standards for Flexible Bronchoscopy in Adults”.¹
Using the Northern Ireland Electronic Care Record (NIECR) we reviewed the following areas for all procedures carried out during this study: the sedation given during EBUS; the use of staging computed tomography (CT) prior to EBUS; sensitivity of EBUS; and the occurrence of complications.
In terms of sedation we used on average less than the usual maximum dose of midazolam (3.28mg versus 3.5-7mg) but more than the usual maximum dose of fentanyl (64.15mcg versus 50mcg).
All patients (n=53) had appropriate CT imaging prior to EBUS (target 100%).
85% of samples were diagnostic (target >88%).
Complications occurred in 3.7% of cases (target <1%) and included sedation reversal.
Our results suggest that exceeding the advised maximum dose of sedatives can lead directly to complications such as the need for reversal agents, meaning that missing one target leads to missing others. While we are meeting some of our targets there is still progress to be made in other areas.