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This new guideline covers the rapidly advancing field of interventional bronchoscopy using flexible bronchoscopy. It includes the use of more complex diagnostic procedures such as endobronchial ultrasound, interventions for the relief of central airway obstruction due to malignancy and the recent development of endobronchial therapies for chronic obstructive pulmonary disease and asthma. The guideline aims to help all those who undertake flexible bronchoscopy to understand more about this important area. It also aims to inform respiratory physicians and other specialists dealing with lung cancer of the procedures possible in the management and palliation of central airway obstruction. The guideline covers transbronchial needle aspiration and endobronchial ultrasound-guided transbronchial needle aspiration, electrocautery/diathermy, argon plasma coagulation and thermal laser, cryotherapy, cryoextraction, photodynamic therapy, brachytherapy, tracheobronchial stenting, electromagnetic navigation bronchoscopy, endobronchial valves for emphysema and bronchial thermoplasty for asthma.This guideline is based on the best available evidence. The methodology used to write the guideline adheres strictly to the criteria as set by the Appraisal of Guidelines Research and Evaluation (AGREE) collaboration http://www.agreecollaboration.org/1/agreeguide/. Three hundred and eighty-seven papers were critically appraised using the Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists. A web-based guideline development tool (http://www. bronchoscopy-guideline.org/) enabled each pair of reviewers to collaborate online. The reliability of the evidence in each individual study was graded using the SIGN critical appraisal checklist. The body of evidence for each recommendation was summarised into evidence tables, formulated into evidence statements and graded using the SIGN grading system into recommendations.

tions in the appearance or function of a modified spray that had been exposed to 150 cycles of a 150'C autoclave as well as 50 cycles of a 134°C autoclave. Probably many other hospitals may need to pay close attention to this unnecessary, potentially dangerous source of hospital-acquired infection.

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