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The University of Chicago Medicine - Comer Children's Hospital

Bronchoscopy FAQ

Read frequently asked questions about bronchoscopy.

The bronchoscope is a small, flexible tube which can be easily passed through a child's nose. The flexible tube carries a fiber-optic system that attaches to a video camera and light source. The image from the open end is transmitted through the fiber-optic system to a video camera.

A trans-nasal flexible fiber-optic bronchoscopy is a procedure where a physician examines various parts of your child's respiratory system through the bronchoscope. The following are some helpful definitions:

  • Trans-nasal: The soft tube of the bronchoscope being passed through the child's nose
  • Flexible bronchoscopes: Soft, flexible, and easily passed through the nose and airways in the lungs
  • Fiber-optic: The ability of the bronchoscope to carry an image from the tip of the tube to video camera

Bronchoscopy is an evaluation of the respiratory system, including voice box (larynx), wind pipe (trachea), and the airways (bronchi) for evidence of any abnormality. Your child's physician can see these structures during different stages of the breathing cycle. He or she can also take pictures and record the images on video. This video image is helpful for the University of Chicago Medicine Comer Children's Hospital physicians to monitor the progress of any abnormalities. 

In a bronchoalveolar lavage (BAL), the physician injects a small amount of saline through the bronchoscope into the airways and then sucks it back through the bronchoscope. The fluid obtained contains saline plus secretions from the lung, bacteria (if present), and cells. This sample is sent to the laboratory for various tests. 

Your child will not be allowed to eat or drink for four hours prior to the procedure. This is very important in order to avoid vomiting.

Once your child arrives, our staff takes his or her height, weight, and vital signs. He or she is then brought to the procedure suite. You will be asked a series of questions and your child will be examined.

Your child will receive an intravenous (IV) line. Monitors are attached to your child in order to watch vital signs. Small children may need to be swaddled. Your child will not be restrained unless absolutely necessary for his or her safety

At the University of Chicago Medicine Comer Children's Hospital, our experts take every step available to ensure the safety and comfort of your child. Typically, a flexible bronchoscopy is not done under general anesthesia, but your child will be given medications via the IV for sedation. Your child will be able to wake from this deep sleep and be able to cough, sneeze, or try to speak if directed.

Numbing drops will be used to numb the nose, back of the throat, larynx, trachea, and bronchi. Lidocaine prevents irritation, cough, and sneezing.

Once the numbing medication takes effect, the bronchoscope is inserted. 

Once the IV is in and all monitoring equipment is attached, the procedure takes less than 15 minutes to complete. If a bronchial alveolar lavage is needed, this takes a few additional minutes.

After the procedure, your child will be monitored while the effect of sedation and numbing medicine wears off--usually about 30 minutes. In order for you child to go home, he or she must be fully awake, able to drink clear fluids, and no longer exhibit signs of sedation. The full recovery process takes around an hour. Your child's physician or nurse will be able to tell you the approximate time for your child. 

Although each child is different, there are usually little or no side effects from this procedure. Some of the possible side effects include:

  • Fever: A mild fever may occur but is rare. Over-the-counter fever medicine will help.
  • Nosebleed: Since the lining the nose is very delicate, a nosebleed may occur. Typically, it will stop on its own.
  • Stridor: If your child has stridor, it may temporarily get worse due to the effect of the medicine used during the procedure. A change in voice or noisy breathing may occur, but is also usually temporary.
  • Wheezing: Some children with a history of lung disease, such as asthma, may need additional medication to treat signs of wheeze both prior to and after the procedure.

Your child's doctor will give you personalized instructions prior to the procedure. This information will instruct you not to feed your child for four to six hours before the procedure.

If your child is old enough, it is important to prepare him or her. Explain as much as you feel he or she can understand.

The following information will help ensure a smooth procedure:

  • Pack one or two favorite toys, blankets, or activities to help your child relax before and after the procedure.
  • Pack a favorite snack or lunch for you and your child. He or she will have to eat before going home.
  • Make sure you know the names and amount of any medications your child is taking--or bring the bottles with you.
  • If your child has any other medical condition, you will need to tell the physician performing the procedure. For example, children with heart problems may need antibiotics prior to and/or after the procedure.