Bronchoscopy

A patient's guide

Important information:

• The time on your appointment letter is the time you need to arrive at the Day Treatment Centre.

• It is not the time your procedure will happen.

• You may have to wait for a few hours before your procedure starts.

• Please come prepared. It's a good idea to bring something to read.

• Please tell the hospital as soon as you can if:

  • You need a translator or interpreter.
  • You take blood thinners or diabetes medicine.

• Tell the Nurse or Doctor if you have a pacemaker, defibrillator, artificial hips, or any other metal implants.

• If you do not have someone to take you home after your procedure, please tell the endoscopy Nurses as soon as possible.

• The endoscopy room is a restricted area. Friends and family cannot come inside.

• We have a trained team of Nurses and Doctors to look after you. If you need an interpreter, we can arrange one by phone or in person.

• If your appointment time is not good for you, or if you cannot come, please contact the Booking Services team on 020 7288 3822 or email whh-tr.endoscopy@nhs.net

• If you have questions about your test or medicines, please call the hospital switchboard on 020 7272 3070 and ask for bleep 2711 (Monday to Friday, 8:30 to 17:30). You can also call 020 7288 3811/3819 or email whh-tr.endoscopypreassessment@nhs.net

• Please do not bring valuable personal things to the hospital. We cannot keep them safe, and there are no lockers to keep them in.

What is a bronchoscopy?

• A bronchoscopy is a test where a small camera looks inside your airways.
• The tool used for this test is called a bronchoscope. It goes in through your nose or mouth. The bronchoscope is soft and bendy, with a light and camera on the tip.
• The test normally takes around 20 minutes.
• It can be a bit uncomfortable but is not painful.
• You can choose to have sedation (medicine that helps you relax) or throat spray (local anaesthetic to numb your throat.).

Intravenous sedation

• If you choose to have sedation you will be injected into a vein. This injection will contain medicine to help you relax and reduce any pain.
• The sedation will make you feel calm and a bit sleepy, but you will not be fully asleep.
• You may still notice what is happening and be able to follow simple instructions.
• We will check your heart rate, breathing and blood pressure during the test.
• If you choose sedation, you must have someone to take you home afterwards. If you cannot find someone, please tell one of the endoscopy Nurses using the phone numbers given.

Throat spray

• We can spray a medicine (xylocaine) onto the back of your throat to make it numb. It tastes bitter but works quickly.
• The spray helps the camera go down your throat without you feeling it.
• The good thing about using the spray is that you stay fully awake and can go home by yourself soon after the test.
• Your throat will stay numb for about 45 minutes. Do not eat or drink anything during this time.

How do I prepare for my procedure?

• Do not eat any food for at least 6 hours before your test.
• If there is food in your stomach, it can move up into your throat when the camera goes in.
• This can be is dangerous because the food could go into your lungs and cause an infection.
• You may have a few sips of clear fluids (such as water, black tea, black coffee with no milk, or herbal tea) up to 2 hours before your test.
• If you do not follow these instructions, your test will be cancelled.
• Keep taking your regular medicines unless the endoscopy Nurse or your Doctor has told you to stop.

What happens when I arrive in the endoscopy unit?

• When you arrive, we will ask you to fill in a short form with your details and information about any medicines you are taking.
• Please bring the medicines you are taking, or an up-to-date prescription list. If you cannot fill in the form, we will help you.
• A Nurse will see you and ask a few questions about your health. This is to make sure you are well enough to have the test.
• The Nurse will also check your heart rate, blood pressure, and oxygen levels. If you have diabetes, we will also check your blood sugar.
• The Nurse will ask you about how you are getting home. If you are having sedation, you must have someone to take you home.
• If you have chosen sedation, the Nurse will put a small tube (cannula) into your arm. If you have chosen the throat spray, the Nurse will give this just before the test.
• You will then go to the waiting area until it is time for your test.
• Remember: The time on your appointment letter is the time you need to arrive, not the time of your test.

What happens during the procedure?

• A team member will take you outside the procedure room.
• The respiratory consultant will explain the test and ask you to sign a consent form. This is your chance to ask any questions.
• When everything is ready and we have finished all the checks, we will give you the throat spray.
• You will sit upright for the test. The Nurse will place a small mouthguard in your mouth. This protects your teeth and gums during the test.
• The Doctor will put the bronchoscope into your nose or mouth. The bronchoscope is put down your throat until it reaches the bronchi (airways in your lungs).
• Any saliva or fluid in your mouth is removed with a suction tube, like the one used at the dentist.
• Please note: Whittington Health is a teaching hospital. Sometimes a student Doctor or Nurse may watch your procedure.

Why do I need a bronchoscopy?

• You are having a bronchoscopy to help find out what is causing your symptoms.
• Common reasons for having this test are:
  • Infection
  • Bleeding (if you cough up blood)
  • Abnormal chest X-ray or CT scan
  • Persistent cough (a cough that does not go away)
• Bronchoscopy is a safe test. Serious problems are rare.
• Please read this information carefully and think about the benefits and the small risks before you decide. You will be asked to sign a consent form before the test.
• The main risks are:
  • There is a small chance of bleeding because the camera can sometimes cause a little injury. This usually gets better within 24 hours.
  • There is a slight chance of damage to your teeth or breathing food or liquid into your lungs (this is called aspiration pneumonia).
  • About 1 in 200 people may have trouble breathing when they have sedation. You will be given oxygen, and your heart and breathing will be checked during the procedure to help keep you safe.

What are the alternatives?

• Sometimes, Doctors can get information from other tests, like breathing tests, a CT scan, or an X-ray.
• These can help show how your lungs are working or if there are any changes inside them.
• But these tests do not always give enough detail. They cannot take samples (biopsies) from your lungs or see inside your airways like a bronchoscopy can. This is why a bronchoscopy may still be needed.

What happens after the procedure?

• The Nurses will keep checking your breathing, heart rate, and oxygen during and after the test.
• We will ask you to stay for about 2 hours after the test, depending on how quickly you recover. This is to make sure you are feeling well and safe before you go home.
• When you have recovered, you will be offered some food or drink. You can also bring your own food if you prefer.
• You should not feel pain after the procedure.
• Before you leave, the Nurse or Doctor will give you a copy of the report. They will explain what was seen and if you need any medicines or another test.
• If you live alone, you must arrange for someone to stay with you overnight.
• For the next 24 hours after sedation, you must NOT:
  • Drive
  • Drink alcohol
  • Use heavy machines
  • Sign any important documents.
• Most people feel completely normal again after 24 hours. If you still feel sleepy, wait another 24 hours before driving.

After you go home

• If you experience chest pain, vomiting, high temperature or you cough up blood, please go to your nearest Hospital Emergency department - please take a copy of your endoscopy report with you.
• For any other queries, you can contact the endoscopy department:

Endoscopy Department

Tel.: 020 7288 3811/3819

Email: whh-tr.endoscopypreassessment@nhs.net

Respiratory Team

Tel.: 020 7288 5353/5354

Email whh-tr.respiratoryteam@nhs.net