Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
The bronchoscopy is performed in one of three areas:
A special room designated for
bronchoscopies and similar procedures
An operating room
An intensive care unit
During the procedure, doctors provide an agent to sedate the patient (such as midazolam (Versed) and /or a narcotic (for example,
the patient remains conscious (so-called conscious sedation "twilight sleep"). Recently, propofol (a short acting , intravenous hypnotic agent) has become more commonly used as an anesthetic agent for bronchoscopies. Lidocaine also can be used to anesthetize the patient's upper airways.
The patient will be monitored during the procedure with periodic blood pressure checks, respiratory rate, continuous
electrocardiogram (ECG, EKG) monitoring of heart and oxygen measurement. Monitoring is extremely important in all forms of anesthesia.
The doctor can insert a flexible bronchoscope through either the nose or mouth. The patient can be either sitting or lying down.
Once the bronchoscope is inserted into the patient's upper airway, the doctor will examine the vocal cords. The doctor continues to advance the instrument to the trachea and on down, examining each area as the bronchoscope passes.
If doctors discover an abnormality, they may sample it, using a brush, a needle, or forceps.
Doctors can obtain a specimen of lung tissue (transbronchial biopsy) often using a real-time X-ray (fluoroscopy). This specimen contains actual lung tissue which may include samples of the air sacs, airways, blood vessels, and supporting membranes of the lungs.