Having a Bronchoscopy

MB BAO BCh FRCPI FRCP (Edin)

Dr SJ Linnane

Having a Bronchoscopy

What is a bronchoscopy?

A bronchoscopy is a procedure which lets the Doctor look into the air passages of your lungs and collect samples to help diagnose your condition.

This involves the doctor passing a narrow, flexible tube called a bronchoscope through your mouth and into the air passages and lungs.

Why is it necessary?

By looking closely at the air passages the doctors may be able to find the cause of your breathing problems. This will help to assess your condition so that they can decide if any further treatment is needed.

How do I prepare for the bronchoscopy?

On the day of the test it is important that you do not eat and drink for at least four hours before the scheduled time of the test.

You will also need to make arrangements for somebody to bring you to and from the hospital as you will not be able to drive yourself home following your bronchoscopy. You should also ensure that there is another adult to stay at home with you on the day of your procedure.

You should wear light comfortable clothes including a loose fitting open necked or buttoned top eg shirt or blouse. Avoid jewellery and ensure your nails are free of varnish or colouring.

What happens on the day?

You should report to the day unit reception (see map). You will be taken through to the Bronchoscopy unit by one of the nurses. If you have false teeth, you will also be asked to remove these before the procedure. It is also important that you tell the doctor or nurse if you have any crowned or loose teeth.

The nurse or doctor will explain about the bronchoscopy to you and you will have an opportunity to ask any questions. If not already done, you will then be asked to read and sign a consent form. It is essential that the doctor involved with the bronchoscopy is aware of any allergies or bad reactions to drugs you’ve had previously.

A small needle called a ventflon will be inserted in to a vein on the back of your hand to allow drugs to be administered painlessly during the procedure.

Before your bronchoscopy

The doctor will give you a sedative injection into the back of your hand, to make you sleepy and relaxed. Your mouth and the back of your throat will be sprayed with local anaesthetic. This ensures that you will not feel the bronchoscope as it is passed into the lungs. You therefore will not feel a need to gag or choke when the bronchoscope is passed.

During your bronchoscopy

The doctor may need to take a small piece of tissue (this is called a biopsy) from your lungs or airways.

X-ray equipment is sometimes used to help the doctor find the right area from which to take the biopsy specimen. Pictures of your airways may be taken to act as a record of the procedure. These may be made available to other doctors to assist them in treating you in the future.

What Risks and Complications are involved?

Sore throat

This is not an infection - it is caused by the Bronchoscope rubbing the delicate lining of your throat. It should disappear within 48 hours. Drinking plenty of fluids or sucking boiled sweets may relieve the symptoms.

Bleeding

If biopsies are taken, you may cough up small amounts of blood-stained spit. This should clear up within a day. If however you continue to bring up blood, please telephone your doctor for advice.

Rarely more significant bleeding can occur during the procedure. If this does occur then it may be necessary to keep you in hospital for observation or blood transfusion.

Fever or flu-like symptoms.

Sometimes you can develop a short-lived fever. This will settle with paracetamol. You may also develop a cough, which will go after a few days.

If you develop infected or coloured sputum which persists beyond a few days then you may require an antibiotic.

Air leak (pneumothorax)

There is a very small chance that the lung maybe punctured during a bronchoscopy. If this happens it may cause the lung to collapse, this is called a Pneumothorax. After certain types of biopsy it is routine to have an x-ray to check for this. If this does occur you will need to stay in hospital and a small drain may have to be inserted into your chest to re inflate the lung.

What happens after the bronchoscopy?

You will rest in your bed until the effects of the sedative have worn off. You will not be allowed anything to eat or drink until your swallowing reflex returns (about 1-2 hours).

You will be told when you can go home but it will be necessary for someone to pick you up and stay with you overnight.

Once at home you should rest quietly for the rest of the day/night. You should not drive, operate machinery, drink alcohol or sign any legal documents for 24 hours after the sedative. You should also not. Some patients find they need to rest the day after the bronchoscopy also.

How will I get my results?

The results of the bronchoscopy will not be available immediately after the bronchoscopy. Samples collected during the procedure will need to be analysed and this can take several days to more than a week depending on the complexity of the analysis.

You will be seen before you leave the bronchoscopy department but information at this time is generally poorly remembered because of the lingering effects of the sedative.

A follow up appointment will be made for you to see your consultant, your results will be discussed with you and a plan of further treatment will be agreed if this is necessary.