Respiratory - Bronchoscopy

What is a Bronchoscopy?

A bronchoscopy is a test which allows the doctor to perform an examination of the air passages of your lungs with a flexible endoscope.

The endoscope is a long thin tube with a bright light at the end. This will allow us to take samples from your airways or lungs if needed. This may involve passing some saline into your lungs and sucking it into a sample pot. Small samples of your lung tubes may be taken through the endoscope and sent to the laboratory for examination.

A small number of patients will need a transbronchial biopsy (a biopsy of the lung tissue). The doctor will inform you if this is needed.

What are the benefits?

This is a non-surgical procedure that provides the opportunity to collect samples painlessly and allows the doctors to give an accurate diagnosis.

Are there any alternatives?

There are no satisfactory alternatives to this investigation to examine the lungs, but a CT scan may be used if necessary.

Do I take my tablets on the day of the test?

If you are on any blood thinning tablets or injections (Warfarin, Synthrone, Clopidogrel, Ticagrelor, Prasugrel, Rivaroxaban, Apixaban, Dabigatran, Edoxaban or Dalteparin) then these will need to have been stopped prior to the procedure and you may need to be issued with alternative medicine. The doctor in clinic should have checked your medicines with you.

If you are taking any of these medicines and you have not been advised when to stop them or are unsure, please can you contact the lung nurses or respiratory secretaries to be advised when to stop these prior to the procedure.

You should take all other tablets as normal.

Allergies

It is important that you tell us if you are allergic to latex (rubber compounds).

We also use lignocaine, midazolam and fentanyl.

What happens on the day of the test?

You will be seen by a nurse on the admitting ward who will ask some basic questions about your health. You will be seen by a doctor who will explain the procedure and ask you to sign the consent form.

Before the bronchoscopy, you may be given an injection to make you feel relaxed (called sedation). A probe will be placed on your finger to measure the oxygen level in your blood.

The doctor will apply local anaesthetic to the back of your throat and nose to numb the feeling. The endoscope will be passed through the nose or mouth into the lungs. The procedure is not painful and does not restrict your breathing. Local anaesthetic will be sprayed onto the vocal cords (voice box) and airways. This might make you cough, but it should settle down quite quickly.

The procedure will take about 15-20 minutes. After the procedure you will be taken to the recovery area to wait until the sedation and local anaesthetic have worn off before you can go home. The recovery time will be about 1 hour.

If you have been given sedation, you should not drive, drink alcohol, sign legal documents or operate machinery for 24 hours afterwards.

If you experience problems after discharge

Please contact the ward that discharged you, the A&E department or your GP.

Are there any risks?

Bronchoscopy is extremely safe.

During the test you will be closely monitored by experienced staff. Minor side effects can include some soreness of the nose and throat for a few days after the test and mild fever which settles with paracetamol.

Coughing up a small amount of blood after the test is to be expected and should settle in a day or two.

More serious side effects (such as breathing difficulties, chest infection and heart problems) are very rare occurring in less than 1 in 1,000 patients. Risk of death is small at less than 1 in 10,000 patients.

If you have had a transbronchial biopsy, there is a small risk of an air leak (approximately 1 in 50 patients). All patients who have transbronchial biopsies will have a chest x-ray after the procedure to check for this. In 90% of patients with an air leak, no action is required. About 10% of patients who have an air leak need a chest drain inserting to allow the lung to expand.

When do I get the results?

Most patients are given a clinic appointment around 1 week later to discuss the results and any treatment which may be offered to you. You can bring a relative, friend or carer to the appointment.

Contact numbers

Respiratory Secretaries:

Lisa Oliver (Oldham) 0161 627 8523
Victoria Mellor (Oldham) 0161 627 8524
Louisa Barker (Bury) 0161 778 2636

Lung Specialist Nurses:

Oldham
Amanda Dand 0161 627 8527 (Weds-Thurs)
Chrissie Charlesworth 0161 627 8527
Angela Findlow 0161 656 1943
Rebecca Parry 0161 778 5481
Zoe Nichol 0161 656 1943

Bury
Lesley Valentine 0161 918 8583
Julie Skinner 0161 778 3789
Paula Hall 0161 778 2693
Jeanette Clarke 0161 778 3214

Lung Pathway Navigators:

Dominique Stretch 07813 994614
Lucy Dixon 07814 829574

Please note: an answerphone service is available - please leave your full name and contact number when leaving a message and someone will return your call as soon as possible.

Your Bronchoscopy has been arranged for:

Date and Time ………………………………………………………
Location ……………………………………………………………..

On the day of the test:

You may have something to eat or drink up to 4 hours before the test.

Please do not have anything to eat or drink after: …………………

You can take medications with a sip of water apart from ones that may have been stopped for the procedure e.g. blood thinning medication.

You must not eat or drink for 4 hours before the test.

As you will be having sedation, it is vital that you arrange transport to and from the hospital and that someone is with you overnight.

Please note that the timing of your procedure is not precise and there may be a delay due to several different factors such as the number and type of cases to be performed.