A postal survey was conducted in The Netherlands among pulmonary specialists in the autumn of 1993. Response was obtained from 74% of the 103 group practices, representing 210 pulmonary bronchoscopists (68% of the total number registered in our country). Eighty-eight percent of the practices comprised four or fewer pulmonologists, 74% had their own bronchoscopy room, 82% had access to fluoroscopy, 95% had day-care facilities allowing bronchoscopic interventions in outpatients, and 67% had intermediate-care facilities with electrocardiogram and pulse oximetry monitoring. Forty-three percent used video-bronchoscopy, of which 82% used the video-adapter. There was a consensus among the pulmonologists about the need for chest x-rays prior to bronchoscopy, atropine as Premedication, and local anesthesia with lidocaine spray. Flexible bronchoscopy was usually performed under local anesthesia without using midazolam. There was less consensus with regard to various other procedures prior to, during, and after bronchoscopy. About 31,000 flexible bronchoscopies were performed each year. Rigid bronchoscopy and broncho-alveolar lavage numbered < 1,500/year and 88% of the pulmonologists performed this procedure less than once a week. Pediatric bronchoscopy numbered less than 280/ year. Interventions, e.g., Nd-YAG laser, were performed only by those working in large hospitals. The majority indicated that bronchoscopic intervention should be concentrated at these institutions only and they did not plan to employ such a technique in the near-future.
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