Bronchoscopy is a procedure performed by a pulmonologist (lung specialist) that allows them to view lungs and air passages to investigate and diagnose a lung problem. A pencil-thin, flexible fiber-optic tube (bronchoscope) with a camera and light attached is inserted into the lungs via nose or mouth, and throat. The doctor examines the respiratory system – larynx, trachea, bronchi, and bronchioles.
If there is bleeding or an object lodged in the airway, a rigid bronchoscope is used. In lung cancer, a bronchoscope with a built-in ultrasound probe called an endobronchial ultrasound (EBUS) can be utilized to provide diagnostic imaging from the inside.
When is a Bronchoscopy Necessary?
A bronchoscopy is a diagnostic tool to examine the airways. It is also a treatment tool to perform small medical procedures. It is ordered for:
· persistent coughs
· chest infections
· abnormal chest X-rays and lab tests
· samples of mucus or tissue
· removal of foreign bodies or blockages
· removal of obstructions or tumors
· placement of stents for a procedure
· examination of collapsed lungs
· delivery of medications
This procedure provides the data your doctor needs to draw up the best treatment plan for you.
Preparing for a Bronchoscopy
The procedure takes between 30 to 90 minutes. The total time including preparation and recovery takes between two to four hours.
Medications
Tell the doctor about other medical conditions, medications, and allergies.
You might have to stop blood-thinning medications several days before the procedure.
If you have glaucoma or myasthenia gravis, he will adjust your pre-procedure medications.
If you have diabetes, your doctor will recommend either to not take or halve the dosage as necessary on the day.
Diet
On the date of your bronchoscopy, your stomach needs to be empty to lessen the risk of vomiting or gagging during the procedure. Empty your bladder.
Stop eating all solid and liquids foods six hours before your appointment. Any essential medications should be taken with just enough water to swallow.
Other preparations
· Leave all jewelry at home
· Remove any dentures, partial dentures, or bridges
· Remove hearing aids, contact lenses, or glasses
· Leave small children at home
· Name a responsible adult as designated driver to take you home. Your chaperone should stay throughout the procedure.
What Happens During the Procedure
A doctor and assistants specially trained in bronchoscopy will perform the procedure. The ordering and performing doctors would have determined the necessary test(s).
· He will discuss your health history, current medicines, and allergies.
· You will be taken through the consent form.
· You will change into a hospital gown.
· The procedure is performed in a specially-designed room.
· An intravenous line (IV) will deliver a mild sedative that will be adjusted as needed during the bronchoscopy.
· You will be connected to heart and blood pressure monitoring equipment.
· Your nose and throat will be sprayed with a local anesthetic. You will be able to breathe normally.
· Medication will be administered through the bronchoscope to numb the airways.
· Oxygen might be administered.
· The doctor will examine your lungs and airways, and perform a biopsy if needed.
The procedure is usually painless, even if a biopsy is conducted.
What Happens in Recovery?
After your procedure you will be taken to the recovery area. Your designated companion can join you there.
· You’ll be monitored for several hours.
· Your mouth and throat will feel numb.
· You can’t to eat or drink until the numbness wears off to prevent food and liquids from entering airways and lungs.
· When mouth and throat are no longer numb you will be given a drink.
· When swallowing is possible soft foods such as soup and applesauce will be given.
· You will experience mild sore throat, hoarseness, cough, or muscle aches.
· The doctor may order a chest X-ray immediately after your procedure.
· The nurse will explain your discharge instructions and answer any questions.
· When the recovery team is satisfied, you will be allowed to go home.
Self–care at Home
A family member or friend should stay with you until you are fully recovered and independent.
You will have clear, written instructions about resuming your activities, medications, and diet. Clarify any doubts or questions about this document, your condition, or your treatment plan before leaving for home.
· You may resume work or school the next day
· Do not drive a vehicle or operate machinery for at least 12 hours
· Do not make any major legal or financial decisions around your procedure
· Do not drink alcoholic beverages for at least 12 hours.
· Use warm water gargles and throat lozenges to reduce throat discomfort.
Complications and Risks
These are uncommon, usually minor, and only rarely severe. Complications may arise from the procedure itself or the sedatives used.
· Cough, hoarse throat or sore nose for a few days
· Minor, temporary bleeding that does not need treatment.
· Rarely, collapsed lungs if an airway gets injured or punctured and air collects in the space around the lung.
· Low-grade fever that generally does not need treatment.
Call your doctor immediately if:
• fever persists longer than a few days
• chest pain escalates
• breathing becomes difficult
• excess blood appears in phlegm
After the Bronchoscopy
The bronchoscopy results should arrive between one to three days after the procedure. Your doctor will review these and discuss them with you, he will use the results to draw up a treatment plan for any lung problems that were found. He may order other tests.
A biopsy will be reviewed by a pathologist. Results may take longer as the tissue samples need special preparation and investigation. Some biopsy specimens need genetic testing, which might take two weeks or more.
At Lung & Sleep Specialists of North Texas, we perform bronchoscopy and other diagnostic procedures, as needed. To make an appointment with Lung & Sleep Specialists of North Texas, call (817) 594-9993 today, or request an appointment online.
