BRONCHOSCOPY

P E D I A WA R D 1 G R O U P
WHAT IS BRONCHOSCOPY?
- It is a procedure in which a hollow, flexible tube called a bronchoscope

is inserted into the airways through the

nose or mouth to provide a view of the
tracheobronchial tree.
- It can also be used to collect bronchial and/or lung secretions and to
perform tissue biopsy.
- The procedure is used to examine the mucosal surface of the airways for
abnormalities that might be associated with a variety of lung diseases.
PURPOSE
• During a bronchoscopy, the physician can visually examine the lower airways,
including the larynx, trachea, bronchi, and bronchioles.

• Bronchoscopy may be used to examine and help diagnose:

diseases of the lung, such as cancer or tuberculosis
congenital deformity of the lungs
suspected tumor, obstruction, secretion, bleeding, or foreign body in the
airways
airway abnormalities, such as tracheal stenosis
persistent cough, or hemoptysis, that includes blood in the sputum
PURPOSE
Bronchoscopy may also be used for the • Bronchoscopy can also be used to
following therapeutic purposes: collect the following biopsy specimens:
to remove a foreign body in the sputum
lungs tissue samples from the bronchi or
to remove excessive secretions bronchioles
cells collected from washing the
lining of the bronchi or bronchioles
 RISKS

Main risks of bronchoscopy are: • Risks when general

•Bleeding from biopsy sites
•Infection
anesthesia is used include:
There is also a small risk of: •Muscle pain
•Abnormal heart rhythms
•Breathing difficulties
•Change in blood
•Fever pressure
•Heart attack, in people with existing heart •Slower heart rate
disease
•Low blood oxygen •Nausea and vomiting
•Collapsed lung
•Sore throat
HOW THE TEST IS PERFORMED?
• A bronchoscope is a device used to see the inside of the airways and
lungs.
• It can be flexible or rigid.
HOW THE TEST IS PERFORMED?
 Bronchoscopy is usually performed in an endoscopy room.
1. The patient is placed on his back or sits upright.
2. A pulmonologist,sprays an anesthetic into the patient's mouth or throat.
3. When anesthesia has taken effect and the area is numb, the
bronchoscope is inserted into the patient's mouth and passed into the
throat.
4. If the bronchoscope is passed through the nose, an anesthetic jelly is
inserted into one nostril. While the bronchoscope is moving down the
throat, additional anesthetic is put into the bronchoscope to anesthetize
the lower airways.
 HOW THE TEST IS PERFORMED?
5. The physician observes the trachea, bronchi, and the mucosal lining of
these passageways looking for any abnormalities that may be present.
6. If samples are needed, a bronchial lavage may be performed, meaning
that a saline solution is introduced to flush the area prior to collecting
cells for laboratory analysis.

Very small brushes, needles, or forceps may also be introduced

through the bronchoscope to collect tissue samples from the
lungs.
HOW THE TEST IS PERFORMED?
NURSING
INTERVENTIONS
PRIOR BEFORE THE
PROCEDURE
 PRIOR BEFORE THE PROCEDURE
• Avoid eating or drinking anything for 6 to 12 hours before the test.
• Not to take any aspirin, ibuprofen, or other blood-thinning drugs before the
procedure.
• Arrange for help with work, child care, or other tasks, as the patient will
likely need to rest the next day.
• Child may be given atropine by injection to reduce bronchial secretion.
• Encourage bronchial relaxation.
• A sedative or conscious sedation usually is administered to help the patient
relax.
NURSING
INTERVENTIONS
DURING THE
PROCEDURE
 DURING THE PROCEDURE
• Patient is usually anxious during the procedure, make her/him feel at ease. Room

should be quiet and patient should be seated comfortably or positioned supine with

head tilted slightly backwards.

• Dentures should be removed.

• Towel should be placed on patient to prevent soiling.

• Nurse should call doctor to check what extent the patient is anesthetized.

• Blood pressure and heart rate should be checked often during the procedure.
 DURING THE PROCEDURE
• Monitor patient's the oxygen level.

• Encourage the patient not to talk while the tube is inserted to prevent sore
throat after the procedure.

• Monitor Electrocardiography routinely if the patient has a known history

of severe cardiac disease.

• The nurse must look for any changes in breathing pattern, chest pain or
any other signs of discomfort.
 DURING THE PROCEDURE
• Staff should wear protective clothing in accordance with local infection-control
policies
• During and after the procedure, the nurse assisting the bronchoscopist will
need to document the patient’s oxygen saturation levels, percentage of oxygen
administered during the procedure, administration of sedation and related
drugs, and any samples taken.
• Any adverse events, including bleeding and wheezing, should be documented .
NURSING
INTERVENTIONS
AFTER THE PROCEDURE
 AFTER THE PROCEDURE
• The healthcare team will watch the vital signs of the patient, such as the heart
rate and breathing.

• A chest X-ray may be done right after the procedure. This is to make sure the
lungs are okay.

• Nurse can check the secretions for blood by asking the patient to gently cough
up and spit saliva into the basin
 AFTER THE PROCEDURE
• Throat discomfort may be felt. It is advisable not to eat or drink until the gag
reflex has returned. Some throat soreness and pain with swallowing for a few
days may notice and it is normal.

• Using throat lozenges or gargle may help.

SOURCES:
• http://www.surgeryencyclopedia.com/A-Ce/Bronchoscopy.html#ixzz4PzMHB63L
• http://medind.nic.in/iaa/t14/i4/iaat14i4p1081.pdf