Description:

This procedure involves passing a flexible tube (bronchoscope) through the mouth to enable a view of the larynx, vocal cords, trachea and bronchi of your lungs. Present uses include diagnostic and therapeutic tasks. The doctor, with the help of the bronchoscopy technician and nurse, will be able to collect liquid and tissue specimens, allowing the doctor to diagnosis and plan the appropriate form of treatment.

Test:

Before the procedure begins a small IV needle will be inserted into a vein in the forearm of the patient, so that the patient can receive some medicine (Versed and/or Fentynal) that will help to relax them and decrease the amount of coughing that may be triggered during the procedure. During the procedure, the amount of oxygen in the patient’s blood and heart rate will be measured using a device called an oximeter (a device clipped to the fingertip which gives an estimate of blood oxygen levels and heart rate). Extra oxygen will be given to the patient through soft rubber tubes placed in front of the nostrils. The patient’s mouth and throat will be numbed by spraying a topical anesthesia called lidocaine. This will eliminate any type of natural gagging and keep the patient from feeling the tube go into your lungs. During this time the patient will continue to receive medication, so that when their throat is completely numb and the procedure is about to begin the patient will be very relaxed and sleepy. However, the patient will not be completely asleep as in a major operation. As the scope is passed into the patient’s lungs more numbing medicine will be inserted through the scope to numb the inside of the airways and decrease coughing. The patient should try to take slow deep breaths and relax and not try to talk while the bronchoscope is in the lungs. Talking can cause hoarseness and/or a sore throat after the procedure. The Doctor and his/her staff will then perform the proper tasks needed to make a diagnosis. The doctor may perform a lavage, which consists of instilling liquid into the patients lungs and then suctioning it back out into specimen containers to be later analyzed. Sometimes a small brush may be inserted through the scope to collect mucous or other matter out of the patient's airways. The patient should not feel any pain from this. Occasionally, the examination is done with the aid of x-ray equipment to help the physician locate the exact area from which to take biopsy specimens. It is common to feel pressure or slight tugging when the biopsy specimens are taken. However, pain is unlikely to occur during the procedure. Bronchoscopy is a very safe diagnostic procedure, which carries little risk. Complications are infrequent, however, if they occur, they may include pneumothorax (collapsed lung), bleeding at the biopsy site, allergic reaction to medicine, hoarseness, infection and fever.

Length of Time:

Approximately 1 hour.

Preparation:

No eating is allowed for 6 to 12 hours before the test, depending on your doctor’s orders. Routine lab work will need to be performed prior to the procedure. Inform the doctor ahead of time which medications are safe to take the day of the test. Make sure not to take any aspirin, ibuprofen, or any other blood thinning medications. The procedure will occur after all questions are answered and an informed consent is signed. It is mandatory that someone besides yourself is able to provide transportation to and from the hospital to your place of residence. Please arrive one hour before the test.

Recovery:

After the procedure a nurse will observe you until you are awake enough to go home. You will not be able eat or drink anything for one hour until the numbing medicine wears off. If you do there is a risk that it may go down the wrong way when you swallow. The nurse will then recheck your blood pressure, pulse, and oxygen saturation prior to discharge. The IV will be removed and a chest x-ray may need to be taken. Tell the nurse if you have any chest pain, difficulty breathing, or notice a large amount of blood (more than a tablespoon) in your sputum. It is normal to cough up a small amount of blood for 1-2 days after the procedure.