Many patients are frightened to hear that they need to “insert a tube into their trachea”. In fact, the doctor will strictly assess the indications and contraindications before performing the procedure, and bronchoscopy is safe for most patients as long as they are not overly nervous and cooperate with the doctor. Here is how you, as a patient, need to cooperate with your doctor.
What should I do to prepare for the exam?
What do you need to do?
What do you need to do?
- Tell your doctor if you have any previous history of respiratory disease, such as asthma, chronic obstructive pulmonary disease (COPD), etc.
- If you are taking oral antiplatelet medications (eg, aspirin, clopidogrel, etc.), or anticoagulant medications (eg, warfarin), you generally need to stop taking them for 1 week before you can have a bronchoscopy.
- Inform the physician of previous surgical history and drug allergy history.
- Fast 4 hours before the examination and no water from 2 hours.
- Active dentures should be removed.
- Stop smoking.
Also, your doctor will do the following preparations, which you need to understand and actively cooperate with.
- Assess the indication for the procedure and rule out contraindications;
- Complete the necessary blood tests, such as routine blood work, coagulation, and infection screening, to get a handle on your platelet levels and coagulation function to determine bleeding risk;
- Pulmonary function tests and blood gas analysis are also required if you have chronic lung disease; if you have hypertension or heart disease, an electrocardiogram or even a cardiac ultrasound is needed to assess whether your heart and lungs can tolerate the operation.
- Before the procedure, your doctor will explain the purpose of the test, its significance, adverse effects, and the procedure, and have you sign an informed consent form.
- If you have a splenectomy, an artificial heart valve, or endocarditis, your doctor will usually recommend prophylactic antibiotics.
- If you have asthma, a bronchodilator may be used before the test.
- If hypertension is present, oral antihypertensive medication should be taken in advance.
- Establish intravenous access before the procedure and retain it until the postoperative recovery period.
What to look for during the examination?
For the specific procedure, the nurse will first administer a local anesthetic, which is an anesthetic such as lidocaine by inhalation through the airway and sprayed in the throat. Afterwards, the doctor inserts a bronchoscope through your nose or mouth, which is a long, thin, flexible tube about 4 to 9 mm in diameter with a “mirror” on one end. Each section of the bronchus is examined in a certain order, and if necessary, a biopsy is taken and treatment is performed.
You are awake during the entire procedure.
It is important to note that despite the local anesthesia, you may experience discomfort such as coughing, coughing, or even wheezing during the examination, which is inevitable and usually not serious; if the symptoms are severe, the doctor may give some targeted treatment to reduce your discomfort.
If you are concerned about the procedure and can tolerate general intravenous anesthesia, you may also consider a “painless” bronchoscopy, which means that the test is done under general anesthesia and without consciousness.
What you need to do to cooperate with your doctor during this procedure is:
- Complete breathing and coughing up sputum as requested by the physician;
- Do not cough violently, but take deep breaths to suppress the coughing impulse;
- Be calm and avoid excessive stress or emotional excitement.
What should I pay attention to after the examination?
- Fast food and water for 2 hours after the examination. After the anesthetic wears off, start with a small amount of water and gradually resume eating and drinking.
- If the test causes a small amount of bleeding, take appropriate hemostatic and cough suppressant medications as prescribed by the doctor.
- Some patients, especially those with impaired pulmonary function and sedation, will require continued oxygen for a period of time after the test.
- If a bronchopulmonary biopsy was performed, it may be necessary to undergo chest imaging 1 hour after the biopsy to rule out a pneumothorax.
Co-reviewed by: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Haiyan Tu, Deputy Chief Physician Yue-Li Sun Dr. Jiangtao Cheng