Bronchoscopy

Is a medical procedure involving the direct examination of one's air

passages (the larynx, trachea, and bronchi). A Bronchoscopy is

performed via the use of a flexible, lighted tube called a bronchoscope.

Equipment

The bronchoscope is a piece of equipment that can be directed and

moved around the bends in the larynx, trachea, and bronchi. These

images are transmitted through the bronchoscope either to the

eyepiece or a video screen. An open channel in the scope allows

other instruments to be passed through it to take tissue samples

(biopsies) or to remove fluid. Reasons for the Exam

There are many medical reasons for having a bronchoscopy. The

following are some reasons for performing a bronchoscopy:

Abnormal findings on a chest x-ray

CT scan abnormal finding

3. Coughing up blood

Pneumonia

1.

2.

4.

5.

Tuberculosis

6.

Pain

7. Unexplained coughPreparation for the Test

You will be instructed to make sure your stomach is empty well

bronchoscopy to lessen certain risks, such as vomiting during the procedure. This

means that you cannot have anything to eat or drink after midnight the evening

before the procedure. Specific instructions for preparation are provided beforehand.
The Procedure

Bronchoscopy is usually performed on an outpatient basis. It is performed with the

patient lying on their back. The physician will insert the bronchoscope through your

mouth and throat or through the nose, then down past the vocal cords to your

windpipe and into your lungs. When the tube passes through your vocal cords you

may feel the urge to cough or feel some minor discomfort. The feeling is not unusual

and is temporary. Occasionally, the examination is done with the aid of x-ray

equipment to help your physician locate the exact area from which to take a sample.

Pain is unlikely to occur during the procedure. The benefits of bronchoscopy include:

1. The physician can see abnormalities, like

inflammation or bleeding, through the

bronchoscope that don't show up well on

X-rays.

2. Copious fluid can be removed from lungs.

The physician can insert instruments into

the scope to treat abnormalities or

remove samples of tissue (biopsy) for

further tests.

3.

4.

Alternative Testing

Alternative testing includes X-ray exams,

CT scans and MRI.

5.

Before the Procedure

1. Your physician will explain the procedure to you and offer you

the

opportunity

to ask any questions that you might have about the procedure.
2. You will be asked to sign a consent form that gives your permission to do the

procedure. Read the form carefully and ask questions if something is not clear.

3. Notify your physician if you are allergic to or sensitive to medications, local and

general anesthesia, contrast dyes, iodine, shellfish, or latex.

4. You will be asked to fast for a certain period of time before the procedure.

Your physician will notify you how long to fast, whether for a few hours or

overnight.

5. If you are pregnant or suspect that you may be pregnant, you should notify

your physician. 6. Notify your physician of all medications (prescription and over-the-co

herbal supplements that you are taking.

7. Notify your physician 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.

8. You may be asked to perform thorough mouth hygiene prior to the procedure.

9. If a sedative is given before the procedure, you may need someone to drive

you home afterwards. If the procedure is to be done under general anesthesia,

you will receive a sedative prior to the procedure.

10. Based upon your medical condition, your physician may request other specific

preparation. During the Procedure

A bronchography may be performed on an outpatient basis or as part or your

stay in a hospital. Procedures may vary depending on your condition and your

physician's practices.

Generally, a bronchography follows this process:

1. You will be asked to remove any clothing, jewelry, dentures, or other objects

that may interfere with the procedure.

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

3. You will be asked to empty your bladder prior to the procedure.

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

5. Your heart rate, blood pressure, respiratory rate, and oxygen level may be

monitored during the procedure.

6. You will be positioned sitting upright on a table that can tilt you from a

horizontal to an upright position as well as other positions. Changing positions

aids in the distribution of the contrast dye into different areas for examination.

7. You may be given a sedative to make you sleepy but arousable.

8. Numbing medication will be sprayed into the back of your throat to prevent

gagging as the bronchoscope is passed down your throat into your stomach. The

spray may have a bitter taste to it. Holding your breath while the physician sprays

your throat may decrease the taste.

9. 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.

10. The physician will pass the catheter or bronchoscope down the back of the

throat into the trachea and the bronchus, instilling the contrast dye as the

instrument is advanced.

11. You may experience some discomfort when the catheter or bronchoscope is

advanced. Your airway will not be blocked.

12. Your physician will take several x-rays in various positions.

13. Once all required x-rays have been taken, the catheter or bronchoscope will

be removed. After the Procedure

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 your home. If this procedure was

performed on an outpatient basis, you should plan to have another person drive

you home.

1. 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.

2. You may be instructed to gently cough up and spit any remaining contrast dye

into a basin to aid in clearing your airways. The physician may recommend

postural drainage (lying flat with the head lower than the rest of the body while

the physician or nurse gently pats your back to help drain the secretions).

3. You may resume your usual diet after the procedure, unless your prysician

decides otherwise. You may be advised to wait 24 hours before returning to your

normal activities.

4. Your throat may feel hoarse after the procedure. Your physician may

recommend a throat lozenge or spray.

5. A chest x-ray may be performed 24 to 48 hours after the procedure to assess

the removal of the contrast dye from the airways.

Notify your physician to report any of the following:

fever and/or chills for longer than two to three days after the procedure

2. redness, swelling, or bleeding or other drainage from the IV site

extreme hoarseness or difficulty breathing

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3.