Introduction
Bronchoscopy (pronounced bron-k—s-ko-pee)
is a diagnostic examination of the major air passages
of the lungs. It is done so that your pulmonary physician
can look inside your lungs. Your physician will insert
a bronchoscope, which is a flexible tube about the
width of a pencil, through your nose or mouth and into
your windpipe (trachea).
There are two types of bronchoscopes. The vast majority of procedures
performed by Pulmonary Medical Associates (PMA) utilize a flexible instrument
which consists of many small glass fibers that transmit light and allow
your physician to see clearly through it. A small channel in the instrument
allows small specimens to be obtained. This instrument can be passed
either through the nose or mouth into the air passages. The second type
of bronchoscope is a rigid tube and is used infrequently in the operating
room to perform laser resection of cancer and to remove difficult foreign
bodies.
Why a Bronchoscopy?
There are many reasons for having a bronchoscopy. Common reasons include:
coughing up blood, a persistent cough that has not responded to the usual
medication, and abnormal chest x-ray findings.
Diseases of the lung can be analyzed with bronchoscopy by sampling the
lung tissue through the use of a bronchoscope. Samples are sent to t
laboratory fo analysis, from which your physician can make a diagnosis.
Adults, and children in particular, may inhale foreign bodies, such as
peanuts, denture parts, pins, etc, into the lung. Sometimes a special
grasping device can be inserted into the lung through the bronchoscope
to remove the foreign body.
How Do I Prepare for a Bronchoscopy?
Your physician will review your medications. Some medications could cause
you to bleed excessively. Coumadin (warfarin) and any medication with
aspirin or another NSAID (eg: ibuprofen, naproxen, ketoprofen, etc?)
can do this and need to be held before the procedure. Be sure to tell
your physician about these and all other medications you are taking.
Unless are you told otherwise, you should follow these instructions to
prepare for the procedure:
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The night before your bronchoscopy, DO NOT eat or
drink anything after midnight. You may use a very small amount
of water or juice to swallow necessary medications. It is important
that your stomach be empty to avoid vomiting. |
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Bring someone to drive you home, or arrange for alternate transportation. |
How is Bronchoscopy Performed?
Before the procedure begins, you will receive medication that will
help you relax and reduce coughing and throat irritation. Most patients
will not remember the procedure after receiving these medications.
A small IV needle will be inserted into a vein so that additional
medications can be given.
Your nurse or physician will connect you to a heart and blood pressure
monitor. You will be given extra oxygen through you nose during the
exam. At this point, additional sedative medication may be given through
you IV.
After the small, thin bronchoscope is passed through you nose or mouth
and throat, it goes though you vocal cords into your windpipe and into
your lungs. When the tube passes though your vocal cords, you may cough
and feel like you cannot catch your breath. The feeling is not unusual
and is temporary. Your physician will stop to let you catch your breath
before continuing the examination.
During the procedure medicine will be administered through the tube
to help relieve any coughing. You can help by taking slow, shallow
breaths through you mouth.
Try not to talk while the tube is in your lungs. Talking can make you
hoarse or give you a sore throat after the procedure.
Occasionally, the examination is done with the aid of x-ray equipment
to help your physician locate the exact area from which to take biopsy
specimens. You may feel pressure or tugging when the biopsy specimens
are taken. However, pain is unlikely to occur during the bronchoscopy.
A nurse and a respiratory therapist will be present during the exam
to assist you and the physician.
Bronchoscopy is a safe diagnostic procedure and carries little risk.
Complications are infrequent, but if they occur, they may include:
What Happens After Bronchoscopy?
When the procedure is finished, you will be observed by a nurse until
you are awake enough to leave. Tell the nurse if you have any chest pain,
difficulty breathing, or notice a large amount of blood (more than one
tablespoon) in your sputum. It is normal to cough after a bronchsocopy
and there may be a small amount of blood in your sputum for few days.
A sore throat, sore nose, mild headache, fatigue and a delayed fever
(several hours) can also develop after the procedure.
The nurse will recheck your blood pressure, pulse, and respiratory rate
prior to your discharge. The IV needle will be removed, and a chest x-ray
may be taken.
You cannot eat or drink anything for 1-2 hours after the procedure because
your throat will still be numb.
When you are ready to be discharged, the nurse will go over some instructions
with you. Most often acetaminophen (Tylenol) will suffice for the sore
throat, aches-and-pains, or fever that can follow the bronchoscopy and
you will be able to resume all prior medications unless told to do otherwise.
Your physician will be happy to discuss any questions you may have regarding
the diagnostic examination and will tell you when to expect the results
back from the laboratory. May tests take a few days or longer to be reported
back by the lab.
Contact your physician if you have any questions or problems after your
bronchoscopy.
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