Bronchoscopy
• Flexible bronchoscopy is the most common type as patients only need to be lightly sedated. This reduces anxiety and suppresses the cough mechanism. Topical anaesthetic, such as lignocaine, is used to anaesthetize the pharynx and the vocal cords. • Rigid bronchoscopy is relatively unusual and is sometimes performed as part of other procedures, such as cryotherapy or laser therapy, where better control of the airway is needed with respect to bleeding. Rigid bronchoscopy needs to be performed under a general anaesthetic. The main indications for bronchoscopy are: • Diagnosis of lung cancer following an abnormal chest X-ray or haemoptysis • Staging of lung cancer • Diagnosis of diffuse lung disease • Diagnosis of infection • Removing foreign bodies, mucus plugs, or excessive secretions.
Nursing considerations
• Explain to the patient what the examination entails and why it is being performed • Advise the patient not to eat or drink for 4–6 h before the test • Advise the patient that a sedative will be given before the test and that a topical anaesthetic will be administered • Advise the patient that they will need to lie on a couch and the bronchoscope will be inserted through their nose or mouth • Advise the patient that a pulse oximeter will be used to continuously monitor their oxygen levels, and that supplementary oxygen will be given if indicated • Report any increase in wheeze, breathlessness, chest pain or haemoptysis to the doctor immediately • Withhold food, fluid, and oral drugs until the gag reflex returns.