You may be advised by your doctor to have a Bronchoscopy. A Bronchoscopy is a test which allows a doctor to look into your windpipe and the airtubes of your lungs. This is done using a flexible tube with a bright light on the end. If necessary, samples can be taken, including biopsies to test for rejection and specimens to test for infection.
X-rays and scans can tell us much about the lungs, but Bronchoscopy gives direct views and allows samples to be taken.
What are the risks of having a Bronchoscopy?
- It’s common to have a sore throat after the examination; this should get better after a few hours.
- There’s a very small risk of damage to teeth, crowned teeth or dental bridgework
- Internal bleeding could occur, but is very rare. A blood sample will be taken before the test to check your clotting levels. Having a small nosebleed or coughing blood can be quite normal, especially after samples are taken. This will usually stop within 24 hours.
- There’s a very small risk of infection. You may develop a temperature in the first few hours after the Bronchoscopy especially if you have had a lavage (fluid passed through the lungs to wash them out). This can stir. up any infection already present. The temperature will usually resolve within 24 hours or may need treatment with antibiotics.
How do I prepare for the Bronchoscopy?
- If you have Diabetes or are taking Warfarin, Clopidogrel or other blood-thinning treatment please inform the Transplant clinic as soon as possible.
- You will need to take all your usual medication early except your anti-rejection medication. This can be taken immediately after having your bloods taken.
- Do not eat anything after midnight the night before the procedure.
- You may drink a little water with your tablets the morning of the procedure.
- Before the procedure you will attend the transplant clinic at 7:30am and will see a transplant nurse, have your bloods taken and be able to discuss any problems or worries.
- Please leave all valuables at home.
- At least one finger should be free of nail polish on the day of the procedure to allow measurement of your oxygen levels during the test.
What will happen during the Bronchoscopy?
- Your test will be performed by one of the transplant consultants or the transplant registrar supervised by the consultant.
- The test will be explained again and you will be asked to sign a consent form giving your permission for the test to go ahead, if you have not already done so.
- A nurse will remain with you throughout the procedure.
- You will be asked to remove any dentures or glasses. You can wear your normal clothing.
- You will be asked to lie on a couch. The doctor will spray your throat with local anaesthetic which will make your throat feel numb and tastes bitter.
- A plastic mouth guard may be placed in your mouth to protect your teeth and the scope. However, for most people the bronchoscope can be passed easily through the nose.
- You will be given an injection through a needle to make you relaxed and sleepy. This is not a general anaesthetic and you will not be unconscious, but it is unlikely that you will remember anything about the test.
- A clip will be lightly attached to your finger to record your pulse rate and level of oxygen in the blood and your blood pressure may also be monitored.
- You will be given oxygen into your nostrils.
- Once you are sleepy the bronchoscope will be passed through your nose or mouth into your windpipe.
- If any samples are needed, the doctor can take these easily and painlessly.
- Photographs of the affected area may be taken for your medical records and will only be seen by those involved in your care.
- The test takes about 10-20 minutes.
What will happen after the Bronchoscopy?
- You will be admitted for an overnight stay to recover from the procedure. This will either be on one of the cardiothoracic wards or ward 38 the transplant ward.
- You will be advised when you can eat and drink, usually two hours after the test.
- You will attend the transplant clinic the next morning. You will be seen by the consultant at the end of the clinic, this will allow time for all your results to be collected.
- If your results show evidence of rejection and/or infection you may have to remain in hospital for further treatment.
- If your results are satisfactory you will be discharged home from the clinic.
For 24 hours after the test you should not
- Go to work
- Drive a vehicle
- Operate machinery (including household appliances)
- Drink Alcohol/take sleeping tablets/recreational drugs
- Sign any legal documents
- Have a bath unsupervised
- Be left alone to care for children
Questions or problems?
If you have any further questions you should contact:
Freeman Hospital
Cardiopulmonary transplant clinic
Direct line 0191 223 1151 7:30am — 3:30pm, Monday to Friday.
Telephone advice is available at evenings and weekends from ward 38 staff: 0191 213 887
Hospital switchboard number is 0191 233 6161.
For further information
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS. You can contact them on freephone 0800 032 02 02 or e-mail northoftvnepals@nhct.nhs.uk
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS Choices website at www.nhs.uk. On this website there is an information prescription generator www.nhs.uk/ips which brings together a wealth of approved patient information from the NHS and charity partners which you may find helpful.