BRONCHOSCOPY is a diagnostic procedure that allows direct visualization of the trachea and large airways (bronchi) of your lungs through a slender flexible tube (fiberoptic bronchoscope).
- To visually examine a possible tumor, obstruction, secretions, cavitation, infection, or foreign body that may be seen on an x-ray.
- To remove foreign bodies, tenacious secretions, and mucus plugs from the larger airways of the lung.
- To assist the doctor in diagnosing cancer, tuberculosis, fungal diseases, or other pulmonary diseases by obtaining sample(s) for laboratory tests.
- You will need to arrange to have someone drive you home after the procedure. The procedure will be rescheduled if you do not have someone to drive you home.
- The procedure takes about 30 minutes. You will be observed by nursing personnel for a couple of hours after the bronchoscopy. The bronchoscopy is often done as an outpatient procedure.
- Results from the bronchoscopy are usually available within 48 hours. The final results from tuberculosis testing will not be available for about six weeks.
- There are some potentially serious complications that may occur from a bronchoscopy. These complications require hospital admission to be properly treated.
- Potential for an elevated temperature. It is not unusual to develop a fever four to six hours after the bronchoscopy. This happens in nearly one-third of cases. However, if you develop a persistent fever or if it is over 102 degrees Fahrenheit, be sure to call the office. Tylenol is usually sufficient to treat the bronchoscopy fever.
- Potential for a pneumothorax in one out of every 100 cases. (A pneumothorax is when air gets between the lining of the ribs and lung causing the lung to partially or totally collapse.) If you develop severe shortness of breath or severe chest pain, be sure to call the office or go to the emergency room. Treatment for a pneumothorax requires that a chest tube be inserted to slowly pull this misplaced air out and allow the lung to reinflate.
- Potential for serious, life threatening bleeding in one out of 1,000 cases. If you cough up a cup or more of SOLID blood within 12 to 24 hours after the bronchoscopy, be sure to call the office or go to the emergency room. This will be treated by close observation and possible blood replacement.
PREPARATION FOR THE PROCEDURE:
- Discontinue Plavix, aspirin and/or Coumadin ___________ days prior to the procedure.
- You should have nothing to eat after midnight prior to the procedure.
- If you normally take medicines, check with the doctor to see if it is okay to take them. If it is okay, swallow your medications with only a sip of water.
- Before the bronchoscopy, some blood work will be taken and possibly a chest x-ray. These may be done before the bronchoscopy is performed.
AT THE HOSPITAL:
- A nurse will obtain some vital signs. You will be asked to change into a hospital gown.
- The nurse will also start an IV access so that a sedative can be given later when the bronchoscopy begins.
- You will be taken to the procedure suite where an updraft treatment will be given. You will have a cardiac monitor and oximetry monitor applied. These will stay on throughout the procedure.
- The anesthetic updraft treatment will have an unpleasant taste. You may feel as if something is in your throat. This is normal. Your airway will not be blocked during the procedure. The anesthetic will allow you to tolerate the procedure.
- An anesthetic will also be applied to your nose to decrease the discomfort when the fiberoptic scope is passed.
- The doctor will come in and you will be given a mild sedative. This will help you relax but should not put you into a deep sleep. The lights in the procedure room may be dimmed and the procedure will begin.
- The doctor will begin to insert the fiberoptic scope through your nose and down your throat. This should not hurt because of the anesthetic that you received earlier.
- The tip of this scope has been lubricated with an anesthetic-type jelly to ease passage through your upper airways.
- When the bronchoscope is above the vocal cords, more anesthetic is passed down the tube to anesthetize the deeper areas of your lungs.
- The doctor looks at the tissue, surrounding structures, and colors and performs procedures appropriate to your specific condition.
- Suctioning of tenacious secretions or mucus plugs.
- Bronchial washings for cultures and cytology.
- Biopsy of lesions or tumors.
- Fluoroscopy may be used in some cases.
FOLLOWING THE PROCEDURE:
- You will not be allowed to drive after the procedure. Someone must drive you home.
- Rest in bed with the head raised about 45 degrees for 1-2 hours.
- If you cough up any sputum, let the nurse see this. If there is blood streaking in the sputum, it is normal. Any excessive bleeding will be immediately reported by nurses to the doctor. If you cough up a cup or more of solid blood within 12 to 24 hours after the bronchoscopy, call the office immediately or go to the emergency room.
- When the anesthetic wears off, you can resume your normal diet.
- Most often, recovery is rapid and uneventful. A day of rest is advised. You may resume normal activities the following day.
- Sometimes the doctor will ask you to collect sputum for 24 hours after the test for additional lab testing. We will provide the containers in which to save the sputum.
- Hoarseness, voice loss, sore throat and blood-streaked sputum are common side effects and clear up by themselves within a few days. Throat lozenges will often make your throat feel better.