Bronchoscopy

Please remain nil per mouth 6 hours prior to your appointment time. Inform your specialist of all prescription and non-prescription medication you are taking, as well as any allergies you may have. Unless otherwise instructed, continue taking any regularly prescribed medication. You may be told to stop taking blood-thinning medications or diabetes medication for several days before the test. Please call the nurses line at the clinic if you are taking these particular medications for further instructions.

A bronchoscopy is performed in a fully equipped examination room. There will be the specialist and two registered nurses in the room with you. You will remain in your own clothing and will be laying on your back with your head slightly elevated. A local anaesthetic spray will be given either in your nose or at the back of the throat. An intravenous sedative is given through an IV cannula. This is called conscious sedation. This means that you may be slightly aware of what is going on in the room, however afterwards you may have very little memory of the procedure. The bronchoscope is inserted through your mouth, down your throat and into your airway. The specialist will spray local anaesthetic into your lungs to numb the area for comfort. Tissue and fluid samples may be taken as well as photographs. The procedure generally takes about 20 minutes.

After your bronchoscopy you will be wheeled into the recovery room where you will rest to allow the sedation to wear off. You will be in the department for at least one hour after the procedure. When you are awake your specialist will discuss your examination results with you and a written summary will be given to you for your reference. A copy of your report will be sent to your GP.

You are unable to eat or drink for two hours following your procedure due to having the local anaesthetic applied to your airway. You will be at risk of serious complications if this instruction is not followed. After the two hours you can take a sip of water. If this is tolerated you can resume a normal diet. If not tolerated, wait 30 minutes and try again.

If you have received sedation you must have someone to take you home after the test and stay with you, as you will be drowsy and unable to drive or operate heavy machinery for 12 hours. The sedative may also affect your ability to recollect details about your procedure. Sedation should wear off in a few hours. You should stay off work the day of your procedure but can resume normal activities the following day.

The specialist may take samples during the bronchoscopy including:

Biopsy – a small piece of tissue is removed from lining of the lungs.

Bronchoalveolar washing or lavage – a saline solution is used to wash the airway of mucous and secretions and the fluid is collected for testing.

Brushing – a brush is passed down the bronchoscope and used to collect cell samples from inside the lungs.

You may be asked to make a follow up appointment with your specialist to discuss your results. The results will also be sent to your GP (may take up to 30 working days).

Complications are rare but may include:

• Bleeding from biopsy site. This usually stops quickly itself but you may cough up a small amount of blood stained sputum afterwards (1-3 out of 100 tests)
• Perforation (pneumothorax) is a hole or tear in the wall of the airway. This is usually associated with a difficult biopsy specimen collection. If this is suspected an x-ray will be requested to identify if any air has escaped your lungs into the chest cavity. The majority of these will heal quickly without the need any treatment. (<3 out of 100 tests)
• Adverse reaction to sedative medication, causing breathing problems or low blood pressure
• Infection requiring antibiotic therapy
• Mortality (less than 0.1%)