- Bronchoscopy should be avoided in suspected or confirmed COVID-19 cases, as this is a highly aerosol-generating medical procedure (AGMP) (tracheal aspirate and NP swab will provide much of the same information).
- If bronchoscopy is absolutely required, only perform on intubated patients, noting:
- Temporary paralysis with rocuronium is recommended when performing bronchoscopy.
- Video bronchoscope only (eyepiece bronchoscope may not be used in suspected or confirmed COVID-19 cases).
Point-of-Care Ultrasound (POCUS)
- While lung ultrasound may be abnormal in patients with COVID-19, the test utility is extremely limited and there is very little quality data.
- We recommend against POCUS for assessing severity or risk-stratification of COVID-19.
- Attention to excellent infection control practices for POCUS is necessary whenever ultrasound is used.
- At this time, CT Chest/Thorax does not confirm the diagnosis or rule out the diagnosis.
- Consider consulting respirology or infectious diseases if you believe a CT chest may help.