Flexible bronchoscopy

A flexible bronchoscopy provides important information to help diagnose and care for your child.

A general anaesthetic is used to inspect the airways without causing your child any distress. The procedure involves a flexible tube and light (the bronchoscope) being passed down the throat and into the breathing tubes. The tube is connected to a camera/video system for observation.

Sometimes a bronchoscopy is done in conjunction with other procedures. Usually, these involve suctioning some of the mucus or phlegm that may be present in the breathing tubes.

What does it involve?

• Your child breathes in anaesthetic gases to send them to sleep very quickly (within 10 to 12 breaths).
• An intravenous line (drip) is then connected once your child is deeply anaesthetised in case other anaesthetic drugs are required.
• The bronchoscope is then passed into the airways.
• The process is viewed on a monitor and recorded on a DVD.
• The procedure takes about 30 minutes (including the anaesthetic).

How should I prepare my child?

Six months and older: Fast (nothing to eat or drink) for six hours before the procedure.

Under six months: Fast (nothing to eat or drink) for four hours before the procedure (this usually means they will miss one feed).

The procedure usually happens in the morning so your child’s fasting can start while they are sleeping the night before. Your child will not need extra feeds during the night to cope with missing breakfast.

You will receive instructions regarding these details from the admission office the week before the procedure.

After the procedure

Your child will be observed closely in a recovery ward for 15 to 30 minutes while their oxygen levels are monitored. After this, your child will return to the ward for further observations. If no further intravenous therapy is required the anaesthetic drip will be removed. This does not hurt.

Once your child is awake and alert, they can have small amounts of fluids. Once their observations are stable your child may eat and drink more freely.

Most children are discharged within three to four hours after they return to the ward.

Getting your results

The doctor who performed the procedure will speak to you afterwards to tell you what they found. This usually happens in the ward or the operating theatre parent’s room. If phlegm samples were taken, the results of these tests are usually available within five days.

Your doctor will notify your GP (general practitioner) or paediatrician of the results. Your child might need a follow-up appointment with a respiratory specialist. This will be organised before discharge.

Post-operative problems

• Coughing after a bronchoscopy is common and usually settles without treatment. If your child starts wheezing, medications such as Ventolin may be required. Visit your GP if you are concerned.
• Irritability: After the anaesthetic your child may be a little irritable or agitated. This will settle quickly with a little comforting.
• Pain: Generally the procedure will not cause pain to the breathing tubes or nose. Occasionally there are small areas of bruising around the drip site which may be slightly tender.
• Temperature: Some children develop a temperature after the procedure. If your child gets a temperature you should give them some children’s paracetamol (Panadol) in the recommended doses.

If your child has a continuous or very high temperature, is unusually distressed, or you have any other concerns, you should call the hospital and ask to speak to the on-call respiratory doctor or the doctor who carried out the procedure.

Ongoing treatment

Your child may require ongoing treatment following a bronchoscopy based on the findings of the procedure. This may involve review by a physiotherapist, a course of oral antibiotics or other medication. Our medical staff will discuss this with you after the bronchoscopy if required.

When to seek help

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by Respiratory and Sleep Unit, Children’s Health Queensland. We acknowledge the input of consumers and carers.

Resource ID: FS019. Reviewed: January 2017.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.