Bronchoscopy

Bronchoscopy

The trachea and tracheobronchial tree are directly seen during bronchoscopy using a fiberoptic or conventional metal bronchoscope. To collect samples for cytologic analysis, the bronchoscope may be passed through with a brush, biopsy forceps, or a catheter.

Purpose

• To visually inspect any potential tracheobronchial blockage, tumor, tumor, discharge, or foreign substance.
• Can aid in the identification of interstitial pulmonary illness, TB, and bronchogenic malignancy.
• To identify a tracheobronchial tree bleeding site.
• To clear the tracheobronchial tree of foreign objects, tumors, whether cancerous or benign, mucus plugs, or excessive secretions.

Patient Preparation

• Describe the procedure to the patient, and explain that this test determines the nature of pulmonary dysfunction.
• Instruct him to fast for 6-12 hours before a test.
• Explain to the patient that the test will take about 45 to 60 minutes.
• Explain the patient that chest x-ray study and blood studies (PT<APTT
• Advise him that he may receive a sedative IV to help him relax.
• Advice to the patient procedure is not performed general anesthesia.
• Check the patient's history for hypersensitivity to an anesthetic.
• Obtain baseline vital signs.
• If a patient is wearing a denture, instruct him to remove them just before the test.

Procedure

• Place the patient in a supine position on a table or bed or have him sit upright in a chair.
• Tell him to remain relaxed with his arms at sides and to breath through his nose.
• After the local anesthetic is sprayed into the patient's throat and takes effect (usually 1-2 minutes), the doctor introduces the bronchoscope through the patient's nose or mouth.
• When the bronchoscope is just above the vocal cords, about 3-4 ml of 2% - 4% lidocaine is flushed through the inner channel of the scope to the vocal cord to anesthetize the deeper area.

Post-Operative Care

• Observe the vital signs. Any negative reaction to anesthesia or a sedative should be reported right away to the doctor.
• Place the cognizant patient in the semi-Fowler posture as directed.
• Give the patient an emesis basin and tell them to spit out their saliva rather than swallow it. If you see any blood or sputum, call the physicians right once.
• 24 hours following the bronchoscopy, collect all sputum for cytologic analysis.
• Keep an eye out for hypoxemia and pneumothorax symptoms.
• For 24 hours following a test, keep resuscitation supplies and a tracheostomy tray accessible.
• Eat little and drink little until the gag reflex appears.
• Assure the patient that the only side effects from his procedure will be temperature, not hoarseness, loss of voice, or sore throat.

References

• https://www.nhlbi.nih.gov/health/health-topics/topics/bron
• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
• www.webmd.com/lung/bronchoscopy-16978
• www.healthline.com/health/bronchoscopy\
• www.mayoclinic.org/tests-procedures/bronchoscopy/home/ovc-2018558
• www.hopkinsmedicine.org › Health Library