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Bronchoscopy Introduction
Carolyn Clary-Macy, RN, OCN, UCSF Thoracic Surgery

Your doctor might order a test called a bronchoscopy. This test uses a thin, flexible lighted tube called a bronchoscope to look inside your lungs. It is usually done to help the doctor diagnose a lung problem such as a mass in the lung, an infection, coughing up blood, a persistent cough or abnormal chest x-ray findings. The doctor may take a biopsy (a small sample of lung tissue) to send to the pathology laboratory for testing. A pumonologist or thoracic surgeon usually performs the bronchoscopy.

The procedure is usually done in an outpatient setting with a local anesthetic and possibly a mild sedative to help the patient relax. In some cases,though, it is done in the operating room with a rigid or stiff bronchscope, so the doctor can use a laser beam if necessary.

Please tell your doctor all prescription and over-the-counter medications you take. Some medications can cause you to bleed. Any medication with aspirin or ibuprofen (i.e. Advil/Motrin) can do this. It is very important that you tell your doctor if you have taken any aspirin or ibuprofen in the past 7 days prior to your bronchoscopy.

Unless you are told otherwise, you should follow these instructions to prepare for the procedure:
1. The night before your bronchoscopy, DO NOT eat or drink anything (not even water) after midnight. It is important that your stomach be empty to avoid vomiting.
*If you are a diabetic, make sure you discuss what to do about eating, especially if your procedure is scheduled for late morning or early afternoon.
2. Your physician should tell you if you should take your medications with a little sip of water on the morning of the procedure.
3. Bring someone to drive you home, or arrange for alternate transportation.

Before the procedure begins, you might be given a medication that will help you relax and reduce coughing and throat irritation. 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 your nose during the exam. An additional sedative medication might be given through your IV.

After the tube is passed through your nose or mouth and throat, it goes through your vocal cords to your windpipe and into your lung. When the tube passes through your vocal cords, you may 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 your 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.

If the doctor takes a biopsy, you mightfeel pressure or slight tugging. This does not usually hurt.

Bronchoscopy is a safe diagnostic procedure and carries little risk. Complications are infrequent, but if they occur, they may include pneumothorax (collapsed lung), bleeding at the biopsy site, allergic reaction to medicines, hoarseness, and fever. Only rarely do patients experience other, more serious complications.

When the procedure is finished, you will be observed by a nurse until you are stable and awake enough to leave. The IV needle will be removed, and a chest x-ray may be taken.Tell the nurse if you have any chest pain, trouble breathing, or if you notice a large amount of blood (more than one tablespoon) in your sputum. It Is normal to cough up a small amount of blood for 1-2 days after the procedure.

You should not eat or drink anything for 2 hours after the procedure because your throat muscles will still be numb.

When you are ready to be discharged, the nurse will go over some instructions with you, such as what to do if you have a sore throat.

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