Bronchoscopy

A bronchoscopy is generally performed to get a sample of a tumor or nodule to determine if it is cancerous and if so, what type of cancer. A bronchoscopy may also include an endobronchial ultrasound (EBUS), which is used to biopsy lymph nodes along your trachea and bronchial tree.

Bronchoscopy may also be used as a treatment for certain situations such as:

•  Control of bleeding in the bronchi from tumors.

•  Laser therapy to clear tumors from the airway to help you breathe  better.

•  Stent placement (a device used to keep the airway open).

•  Drainage of an abscess (a collection of pus).

There may be other reasons for your doctor to recommend a bronchoscopy.

As with any invasive procedure, complications may occur. Complications related to bronchoscopy may include, but are not limited to:

• Bleeding.

• Infection.

• Bronchial perforation (tearing).

• Bronchospasm and/or laryngospasm (irritation of the airways and/or vocal cords).

• Pneumothorax (air becomes trapped in the pleural space causing the lung to collapse).

There may be other risks depending on your specific medical condition.

• Your doctor will explain the procedure to you and offer you the opportunity to ask questions.

• You will be asked to sign a consent form providing your permission to undergo the procedure. Read the form carefully and ask questions if something is not clear.

• Notify your doctor if you are sensitive or allergic to any medications, latex, tape or anesthetic agents (local and general).

• Your doctor will direct you to fast for a certain period of time before the procedure.

• Notify your doctor if you are pregnant or suspect that you may be pregnant.

• Notify your doctor of all medications (prescribed and over-the-counter), vitamins and herbal supplements that you are taking.

• Notify your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

• You will be awake during the procedure, but you will get a sedative. You will need someone to drive you home afterward.

• If you are having a rigid bronchoscopy, your procedure may be performed in the operating room under general anesthesia.

• Based on your medical condition, your doctor may request other specific preparations.

A bronchoscopy may be performed as an outpatient procedure or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Generally, a bronchoscopy procedure follows this process:

• You will be asked to remove any clothing, jewelry or other objects that may interfere with the procedure.

•  If you are asked to remove clothing, you will be given a gown to wear.

• An intravenous (IV) line may be inserted in your arm or hand.

• Your heart rate, blood pressure, respiratory rate and oxygen level may be monitored during the procedure.

• You will be in a sitting position or lying on your back.

•  You may receive oxygen through a nasal cannula (tube) or face mask during the procedure.

•  You may be given a sedative to make you drowsy.

• Numbing medication will be sprayed into the back of your throat to prevent gagging as the bronchoscope is passed down your trachea into the bronchi. The spray may have a bitter taste. Holding your breath while the doctor sprays your throat may decrease the taste.

• You will not be able to swallow the saliva that may collect in your mouth during the procedure due to the bronchoscope in your throat. The saliva will be suctioned from your mouth from time to time.

• The doctor will move the bronchoscope down your throat and into the airways. As the bronchoscope is inserted, the doctor will examine tissues and structures.

• You may experience some discomfort when the bronchoscope is moved further into your airways. It’s important to note that your airway will not be blocked.

• The doctor may get tissue samples for biopsy or other specimens for testing during the procedure. Other procedures may be performed as necessary.

• Once the examination and any other procedures have been completed, the bronchoscope will be removed.

After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse and breathing are stable and you are alert, you will be taken to your hospital room or discharged to go home. If this procedure was performed on an outpatient basis, you should plan to have another person drive you home.

You will not be allowed to eat or drink anything until your gag reflex has returned. You may notice some soreness of your throat and pain with swallowing for a few days. This soreness is normal.

You may be instructed to gently cough up and spit your saliva into a basin. The nurse will monitor your secretions. Your secretions may have a little bit of blood in them.

You may have a chest X-ray performed after the procedure.

You may go back to your usual diet and activities after the procedure unless your doctor decides otherwise. You may be asked to wait 24 hours before returning to your normal activities.

Your voice may sound hoarse after the procedure. Your doctor may recommend a throat lozenge or spray.

Tell your healthcare provider if you experience any of the following:

• Fever and/or chills.

•  Redness, swelling, bleeding or other drainage from the IV site.

• Extreme hoarseness or difficulty breathing.