During a bronchoscopy, if a child begins to cough as the bronchoscope advances, what should the specialist recommend?

When a bronchoscopy is performed, it is not uncommon for the patient to experience sensations that may prompt coughing, especially as the bronchoscope is advanced through the airway. In such scenarios, providing appropriate topical anesthesia can effectively alleviate discomfort and minimize involuntary reactions like coughing.

Cetacaine is a topical anesthetic that can be applied to the airway to numb the throat and reduce the cough reflex during the procedure. By decreasing the sensitivity of the airway, Cetacaine helps create a calmer environment, allowing the procedure to continue with less interference from the child's natural cough reflex.

Other options may not directly address the issue of coughing during bronchoscopy. For instance, succinylcholine, a rapid-acting muscle relaxant, is generally used for intubation and not for managing coughing during procedures like bronchoscopy. Racemic epinephrine is typically indicated for airway swelling and can be useful in treating specific conditions like croup but does not serve to alleviate cough caused by a bronchoscope. Ketamine, while providing sedation and analgesia, may not specifically target the immediate need to suppress a cough caused by the bronchoscope's presence in the airway.

Using Cetacaine helps ensure that the procedure can proceed smoothly and that the patient