Child health

Patient information for Translation

Paediatric Flexible Bronchoscopy

Introduction

Your doctor has recommended that your child has a bronchoscopy to find a reason for their chest problems.  This leaflet explains the procedure and what to expect. 

What is a bronchoscopy?

A bronchoscopy is a procedure where a doctor looks inside the airways with a special long-thin camera called a bronchoscope.  In children this test is done while they are asleep under general anaesthetic, so your child will not be aware or awake while the procedure is happening. 

The doctor passes the camera down each branch of the airway and the pictures can be seen on a video screen.  The airways are a bit like an upside-down tree.  The main tree trunk is the trachea / windpipe – and this then divides into smaller and smaller branches.  We sometimes make a recording of the images so that we can review the pictures later if necessary.  These images are stored securely.

During the procedure samples are usually taken from the airway.  The term used for this is “lavage” which just means washing.  Some salty water is squirted down the bronchoscope into the airways.  This salty water is then sucked back up the bronchoscope along with some secretions that may contain bacteria or viruses or cells.  This information can be very helpful and the results can help decide on the best treatment for your child.

Occasionally in some patients we take a few biopsies (small pieces of tissue each about the size of a pin head) from the airway wall.

What happens when you come for a bronchoscopy?

Before the procedure

You will receive a letter confirming the date of the bronchoscopy, and instructions for fasting.  Your child must not eat anything for six hours before the bronchoscopy.  This is very important because if they eat or drink close to the procedure they can vomit during the anaesthetic.  This can be very dangerous.  Your child may drink water up to 2 hours before the procedure.  If you do not follow these instructions your child’s procedure will be cancelled.

Medicines

Unless advised otherwise your child should continue to take all their usual medicines including any asthma inhalers. There are some exceptions to this as follows:

• If your child is also having an impedance study (a test for gastro-oesophageal reflux disease) then you should stop their reflux medicines (omeprazole, lansoprazole, ranitidine, cimetidine and domperidone) 5 days before the procedure, unless advised otherwise.
• If your child is taking long-term oral or nebulised antibiotics, please stop these one week before the procedure, unless advised otherwise by your doctor.

Most bronchoscopies are performed as a day-case procedure.  If a hospital admission is required, this will be discussed further with you by your child’s doctor.

After arriving at the hospital your child will be seen by an anaesthetist (doctor who specialises in making your child asleep for the procedure) and a respiratory doctor.  You will be asked to sign a consent form. Some patients may require a CT chest and this may be performed before the bronchoscopy.

Parents or guardians can come to the room where the anaesthetic is given.  You will then be asked to leave while the bronchoscopy is performed in theatre. Sometimes the back of your child’s throat is sprayed with some local anaesthetic (numbing spray).  Your child will not be aware at all during the procedure and will not remember it. 

Can your child bring a favourite toy to theatre?

Favourite toys are very welcome to come and stay with your child during the bronchoscopy.  Just make sure we know where your child’s toy is so it is not lost.

Will any other procedures be performed?

It may be a good opportunity to perform some additional tests or procedures, which are easier to do while your child is asleep.  Your child’s doctor will explain if these are recommended before the procedure.  The tests we may consider include:

• A CT scan of the chest – sometimes it is easier to do this while your child is asleep
• An impedance study.  This is a test for gastric reflux.
• Blood tests
• Chest physiotherapy
• For some patients another camera test to look at the upper airway is required by our Ear Nose and Throat doctors. 

If the doctor feels that an admission to hospital is required for intravenous antibiotics, the medical team will take the opportunity to site a long line in your child’s arm while you are asleep.  This is like a cannula (short line) but lasts longer.  This will be explained in more detail by the doctor if needed.

How long will the bronchoscopy take?

The bronchoscopy itself takes about 10-15 minutes.  However your child will be asleep for at least an hour and sometimes longer if other procedures are needed.

What happens after the bronchoscopy?

After the bronchoscopy your child will be taken to the recovery room where they will wake up. You will be called to come and see your child before they are taken back to the ward.  If the back of the throat has been sprayed with local anaesthetic, your child will not be able to eat or drink for about 2 hours after the procedure.  The anaesthetist will advise on the exact timing. Your child will probably feel sleepy for the rest of the day.

Is a bronchoscopy safe and what are the risks?

Bronchoscopy is usually a safe and straight forward procedure.

Some children have a cough or wheeze afterwards, hoarse voice or sore throat but this usually gets better quickly.  Your child can have some paracetamol if their throat is sore. Some children may also cough up tiny blood specks which resolve very quickly.

Sometimes children get a high temperature or fever a few hours after the bronchoscopy.  This usually gets better with some paracetamol.

Please seek medical advice from your child’s doctor if the temperature or cough does not settle, or if you are concerned.

Large print and other languages

This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. For more information, speak to your clinical team.
 

এই তথ্যগুলো সহজে পড়া যায় অথবা বৃহৎ প্রিন্টের মত বিকল্প ফরম্যাটে পাওয়া যাবে, এবং অনুরোধে অন্য ভাষায়ও পাওয়া যেতে পারে। আরো তথ্যের জন্য আপনার ক্লিনিক্যাল টিমের সাথে কথা বলুন।

Na żądanie te informacje mogą zostać udostępnione w innych formatach, takich jak zapis większą czcionką lub łatwą do czytania, a także w innych językach. Aby uzyskać więcej informacji, porozmawiaj ze swoim zespołem specjalistów.

Macluumaadkaan waxaa loo heli karaa qaab kale, sida ugu akhrinta ugu fudud, ama far waa weyn, waxana laga yabaa in lagu heli luuqaado Kale, haddii la codsado. Wixii macluumaad dheeraad ah, kala hadal kooxda xarunta caafimaadka.

Bu bilgi, kolay okunurluk veya büyük baskılar gibi alternatif biçimlerde sunulabilir, ve talep üzerine Alternatif Dillerde sunulabilir. Daha fazla bilgi için klinik ekibinizle irtibata geçin.

یہ معلومات متبادل فارمیٹس میں دستیاب کی جا سکتی ہیں، جیسا کہ پڑھنے میں آسان یا بڑا پرنٹ  اور درخواست پر متبادل زبانوں میں بھی دستیاب ہو سکتی ہیں۔ مزید معلومات کے لیے، اپنی کلینکل ٹیم سے بات کریں'۔

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Reference: BH/PIN/1086

Publication date:  Sep 2021

All our patient information leaflets are reviewed every three years

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