How is a bronchoscopy done? Few people know, but this word sounds intimidating. And not in vain. After all, this is a complex procedure that has certain risks. It is carried out in a sterile operating room, observing all appropriate precautions.
How a lung bronchoscopy is done
Reviews of patients who have gone through this procedure on how bronchial bronchoscopy is done are reassuring. Most importantly, it does not hurt at all, it does not last long, and if carried out correctly, it does not leave negative consequences.
The huge diagnostic and therapeutic capabilities of the bronchoscope more than compensate for the patient's discomfort during the procedure. And yet, what is diagnostic and therapeutic bronchoscopy: how is each of these procedures performed?
At the moment, bronchoscopy is the most effective and visual method for examining and carrying out some therapeutic measures of the internal cavity of the lungs, bronchi and trachea. After inserting an optical bronchoscope inside, the doctor can observe the full picture on the monitor and make an accurate diagnosis.
In addition to diagnostic, therapeutic bronchoscopy is also performed. Feedback from former patients is direct evidence thatthe healing properties of this procedure are very effective: the rapid removal of foreign bodies and pathological substances from the bronchi, the introduction of the necessary drugs.
Types of bronchoscopy
How is bronchoscopy made rigid and how is it different from flexible? A rigid (rigid) bronchoscope is a system of hollow rigid tubes with a flashlight and a camera on one side and a manipulator on the other. A rigid bronchoscope procedure is required to detect a foreign body in the bronchi or airways or to stop bleeding from the respiratory organs.
Rigid bronchoscopy under anesthesia. Since the anesthesia is general, the patient does not experience discomfort, does not move, and does not interfere with the doctor's concentration.
Often, a rigid bronchoscope is used by emergency doctors and resuscitation teams when providing first aid, for example, to a drowned person. This is a fast and effective way to remove fluid from the lungs. If various pathologies are detected during the diagnostic process, a rigid bronchoscope allows the doctor to eliminate them immediately on the spot. With flexible bronchoscopy, this is not possible, the doctor will subsequently have to re-insert the device into the patient's airways.
In the absence of direct indications for a rigid type of bronchoscopy, doctors try to use an elastic fiber bronchoscope, in which case local anesthesia is most often sufficient. It is a smooth tube made of an optical cable with an LED, a video camera on oneend and a control lever on the other.
Although the flexible type of bronchoscopy is considered primarily diagnostic, a special catheter inside the fiber bronchoscope, if necessary, will allow you to remove fluid from the bronchi or introduce drugs into them. It easily and with minimal trauma to the mucous membranes penetrates into the most distant parts of the respiratory organs.
Anesthesia: general or local?
General anesthesia can be prescribed for flexible bronchoscopy, depending on the patient's mentality (childhood, mental instability, shock and stress).
Local anesthesia involves the use of a solution of lidocaine in the form of a spray, they are first irrigated with nasal sinuses, nasopharynx, then as the apparatus advances - the larynx, trachea and bronchi. Lidocaine not only relieves pain, but also suppresses the gag and cough reflex. Only local anesthesia is recommended in the elderly or if the patient has severe diseases of the cardiovascular system.
Conditions for the use of bronchoscopy
Diagnostic bronchoscopy is required in the following cases:
- for tuberculosis;
- smoking experience from 5 years;
- suspected lung cancer;
- lung atelectasis;
- bleeding;
- respiratory obstruction;
- prolonged cough of unknown origin;
- pathology detected on x-rays (inflammation, nodes, seals).
In addition, therapeutic bronchoscopy is prescribed:
- forextraction of foreign bodies from the respiratory organs;
- removal of neoplasms blocking the airways;
- installation of a stent on the airways when they are blocked by tumors.
Preparing the patient for the study
What is a bronchoscopy and how to prepare for it? As a rule, patients learn about this only after realizing the inevitability of the procedure and reading all sorts of literature about how bronchoscopy is done. The positive effect of the procedure depends on the qualifications and responsible approach of the doctor and the careful preparation of the patient.
It will be necessary to first pass several tests and undergo an examination (general and biochemical analysis of blood, urine, pulmonary function test, chest x-ray, electrocardiogram of the heart and some others, in accordance with the patient's disease and the purpose of the study). The doctor will talk with the patient, tell where the bronchoscopy is done, how the examination will take place, what you should mentally prepare yourself for in advance.
In addition, he will offer to fill out a questionnaire in which you must specify:
- existing heart disease;
- blood clotting problems;
- autoimmune diseases;
- drugs to which an allergic reaction is possible;
- Medications taken;
- chronic and acute diseases;
- the state of pregnancy and other features of your body that may affect the course of the bronchoscopy procedure.
When plannedexamination, the patient is forbidden to eat, drink alcohol, smoke for at least 8 hours. The human stomach must be empty. It is acceptable to take laxatives in advance or give a cleansing enema.
Asthma patients are allowed to take an inhaler with them to the operating room. Many patients experience and are very nervous before the study. In this case, a person is recommended to take mild sedatives. The emotional state of the patient is very important - so that during the procedure he is calm and relaxed - otherwise it will be difficult for the doctor to make smooth and very precise movements, on which the effectiveness of the study depends.
Does it hurt to do a bronchoscopy
Contrary to expectations, the bronchoscopy process is painless. When inserted into the tube, a lump in the throat, nasal congestion, numbness of the palate and difficulty in swallowing are felt. The patient's breathing is not difficult because the diameter of the tube is very small.
After treatment
The patient fully recovers and can leave the hospital building, take food, water within 2-3 hours after the end of the procedure. Smoking and drinking alcohol is undesirable during the first two days. If sedatives were taken, then on this day it is better not to drive or drive a vehicle, as they dull the attention, speed and reaction of a person.
Contraindications
Like any other medical procedure, bronchoscopy has a number of contraindications.
1. Relative ifthe case is urgent and there is no way to make a diagnosis by another method:
- pregnancy (2nd and 3rd trimester);
- advanced diabetes;
- enlarged thyroid gland;
- alcoholism;
- bronchial asthma.
2. Absolute, if irreversible harm to he alth is possible:
- the stage of decompensation of one of the diseases of the human cardiovascular system (myocardial infarction, aortic aneurysm, heart disease, heart rhythm disturbances, hypertension);
- respiratory failure or obstruction of the bronchial system;
- thrombosis of vessels - brain or lungs;
- psycho-neurological diseases of the patient (epilepsy, schizophrenia);
- abdominal pain of various origins.
Possible Complications
The procedure for conducting bronchoscopy is quite complicated, if it is carried out correctly, only a slight sore throat remains from discomfort. However, no one is immune from accidents, and complications may emerge in the process:
- Mechanical damage and even puncture of the lung, bronchus and trachea can lead to bleeding.
- Before the procedure, an allergic test is mandatory, for this the patient is injected with a small dose of an anesthetic. But sometimes it happens that the test is passed successfully, and the allergy manifests itself already in the process of the procedure, with an increase in the dose. Possible swelling of the larynx and anaphylactic shock.
- Larynxeach patient is individual, sometimes due to the anatomical features of the bronchoscope can damage the vocal cords.
- If the doctor's recommendations are not followed after the procedure, a significant deterioration in he alth and bleeding is possible.
So, having studied all the possible indications, contraindications and risks, the therapist or pulmonologist determines the appropriateness of bronchoscopy, discusses it with the patient and, with his written consent, appoints the day and hour of the procedure.
