In lung and critical care notes, the BAL medical abbreviation means bronchoalveolar lavage, a procedure that rinses a small part of the lung with sterile salt water during a bronchoscopy and collects the fluid for testing.
In emergency medicine, BAL can also stand for blood alcohol level, a measure of alcohol in the bloodstream. A third, older use is the name British anti Lewisite, another name for dimercaprol, a drug used to treat certain heavy metal poisonings. Where the letters sit in the record usually settles which one is meant.
At a glance
Stands for
Bronchoalveolar lavageOther meanings
Blood alcohol level (emergency care); dimercaprol, British anti Lewisite (toxicology)Word roots
Broncho means airway, alveolar means air sac, and lavage is French for washingDone during
Flexible bronchoscopyFluid is tested for
Infection, cell types, cancer cellsSpecialty
Pulmonology, critical care, emergency medicine
What the BAL medical abbreviation means in lung care
During a bronchoscopy, a thin flexible tube with a camera is passed through the nose or mouth into the airways. The doctor wedges its tip into a small airway in the area of concern, then pushes in sterile saline and gently suctions it back. The returned fluid carries cells, germs, and other material from the tiny air sacs called alveoli.
The procedure is done with sedation and numbing medicine, or under general anesthesia in someone already on a breathing machine. Patients who were not already admitted usually leave a few hours later.
Why a BAL is done
- To find the germ behind a pneumonia, especially in people with weak immune systems or a pneumonia that is not improving
- To look for tuberculosis or fungal infection
- To study cell patterns in ILD, interstitial lung disease
- To check for cancer cells
- To look for bleeding deep in the lungs
In an intensive care unit, BAL samples help guide antibiotic choices for people on ventilators.
Reading a BAL line in a procedure note
Bronchoscopy report: "Bronchoscopy with BAL RLL, sent for cultures, cell count and cytology." A lung wash was done in the right lower lobe. The fluid went to the lab to grow germs, count cell types, and look for abnormal cells.
| Term | Plain meaning |
|---|---|
| RLL, RML, LUL | Right lower lobe, right middle lobe, left upper lobe |
| Cell count and differential | Numbers of each type of white blood cell in the fluid |
| Cytology | Looking at cells under a microscope for cancer |
| Return volume | How much fluid came back out |
BAL as blood alcohol level
In emergency and trauma notes, BAL often means blood alcohol level, the amount of ethanol in the blood. Hospital labs often give the result in mg/dL, but driving limits are usually stated as a percentage, so the numbers look different even when describing the same thing. Some charts use BAC, blood alcohol concentration, or a serum ethanol level instead. Related terms are explained on the ETOH page.
Trauma note: "BAL 180 on arrival, GCS 14." The blood alcohol level was measured when the person came in, alongside a brief level of consciousness score.
BAL as an antidote name and how to tell meanings apart
Dimercaprol was first developed as an antidote to a wartime arsenic gas, which is why it carries the name British anti Lewisite. It is still used for some arsenic, mercury, and lead poisonings and is given by injection into a muscle.
| Meaning | Where you see it | Clue |
|---|---|---|
| Bronchoalveolar lavage | Pulmonary, ICU, bronchoscopy notes | Lobe names, culture, cytology |
| Blood alcohol level | Emergency and trauma notes, labs | A number, often in mg/dL |
| Dimercaprol | Toxicology or medication orders | Metal poisoning, IM injection |
Other test and procedure short forms are gathered in the lab and imaging abbreviation section, and CXR explains the chest X ray often done before and after bronchoscopy.
Questions to ask before a bronchoscopy with BAL
- Why is the lung wash being done, and what tests will the fluid have?
- Will I need to stop eating or drinking beforehand?
- Which of my medicines, especially blood thinners, should I discuss before the procedure?
- When will results be ready, since some cultures take weeks?
General information like this cannot replace a talk with your lung doctor or nurse, who can explain why your own procedure was planned and what the results mean.
Frequently asked questions
What does BAL mean in a bronchoscopy report?
It means bronchoalveolar lavage, a wash of part of the lung with sterile saline. The fluid is sent to the lab for cultures, cell counts, and other tests.
What does BAL mean in the emergency room?
In emergency notes BAL often means blood alcohol level, the amount of alcohol measured in a blood sample.
Is a BAL painful?
It is done with numbing medicine and sedation, so most people feel little. A cough, sore throat, or low fever for a day afterward is common.
What is BAL as a drug?
BAL is an older name for dimercaprol, an injected antidote for some heavy metal poisonings such as arsenic and mercury.