Professor Allen performs bronchoscopy procedures at St Andrews War Memorial Hospital and Wesley Day Surgery.
If you have a bronchoscopy booked you will need to arrive at the hospital no later than 1 hour prior to the procedure. You will need to have fasted (NIL by mouth) for at least 8 hours prior. This includes water. Please discuss the taking of your usual medications with Professor Allen.
Remember to bring any Xrays, scans or CT results as Professor Allen will need them during the procedure.
Dr Allen uses a soft, thin bendable tube (bronchoscope) to look at the voice box and bronchial tubes in the lung. This is to find the cause of lung problems you may have. Small samples of tissue and cells may be removed and sent for tests.
Your nose and throat may be sprayed with a local anaesthetic to make them numb. You may be given a sedative drug by injection in a vein to make you feel more comfortable. Sometimes you will not remember having the bronchoscopy because of the sedative. The bronchoscope will be passed through the mouth or nose down through the voice box into the air tubes in the lungs. More local anaesthetic is used to numb the air tubes. The bronchoscope does not stop your normal breathing. You may cough but this normally settles once the local anaesthetic takes effect. The procedure usually takes between 10 and 30 minutes.
Professor Allen has an anaesthetist to assist him who administers a short acting general anaesthetic.
If samples are taken, they are sent to Pathology for tests. It may take a few days before we get a result.
Bronchoscopy is simple and very safe. It is unlikely to cause problems unless you have serious heart or lung problems. Major or life-threatening complications are very unlikely- about 1 in 300 patients having a bronchoscopy. It always depends on how sick the patient is in the beginning.
- Fever. This may happen after broncho-alveolar lavage and is treated with paracetamol (Panadol). Rarely, you may get an infection
- Asthma-like reactions: The bronchi can be narrowed due to irritation by the procedure. This is usually prevented by premedication with nebulised a bronchodilator such as Ventolin.
- Collapsed lung (Pneumothorax) A small hole in the surface of the lung can happen after a trans-bronchial lung biopsy for up to 1 in 20 people. Air then leaks from the lung, causing the lung to collapse. The lung may come back up itself, but for 1 in 2 people who get a collapsed lung a tube has to be put through the skin into the chest. This removes the air from around the lung and may need a longer hospital stay. Rarely this can happen up to 24 hours after trans-bronchial biopsy or bronchial brushing’s.
- Heart problems Bronchoscopy can cause abnormal cardiac rhythms such as atrial fibrillation.
- Bleeding This can happen after biopsies. Normally it is only minor and settles quickly. If the bronchoscopy is passed through the nose then bleeding from the nose may occur. Severe bleeding is rare and is more common in transbronchial biopsies. Bleeding is more common if you have been taking Warfarin, aspirin or drugs for arthritis or back pain. Ask your doctor if and when you should stop taking such drugs.
- Reactions to sedation or local anaesthetic. This can include vomiting and rare allergic reactions.
- Narrowing of vocal cords (laryngospasm) This is usually short lived and rarely a problem.
- Low oxygen levels (Hypoxemia) During the test your oxygen levels are measured and you may be given oxygen.
- Death is extremely rare – about 1 in 2,500 patients.
Dr Allen is a private billing specialist and will charge a fee, payable in full prior the procedure. After the procedure, you will receive a receipt in the post to which you may make a health fund/Medicare claim. Your private health insurance will cover all or part of this fee, depending on your level of cover.
The hospital and anaesthetist charge separately and again, depending on your level of cover, your out of pocket expenses will vary. You will need to quote the following item numbers when making a health fund enquiry about the hospital fees:
- 41892 Basic Bronchoscopy (day bed, theatre & instruments)
- 41898 Complicated Bronchoscopy (day bed, theatre & instruments)
- 60506 Pathology
You will need to recover from the procedure in the hospital for 2-4 hours, and may have a chest x-ray to make sure your lung has not collapsed if you have had a trans-bronchial lung biopsy or bronchial brushing’s. If you have been given drugs for sedation or a general anaesthetic for your safety you should:
- Be taken home by a responsible adult
- Must not drive a car or motorcycle (this is against the law), operate machinery or drink alcohol for 24 hours after the procedure.
- You should not make any important decisions or sign any contracts within 24 hours after the procedure.
- If you are elderly or frail you may need a responsible adult to care for you that day/night. Ask Professor Allen if this applies to you.
In the 12 hours following the test you may:
- Cough up small amounts of blood
- Have a fever
- Feel sick
- Have a sore throat and hoarse voice.
Contact Professor Allen or the hospital if you have:
- A fever that does not go away
- More than a tablespoon of blood when you cough
Contact Professor Allen or hospital IMMEDIATELY IF YOU HAVE:
- Shortness of breath
- Chest pain
- If you coughed up more than a quarter of a cupful of blood
- Have passed out or fainted.
On the day of your procedure, you must be taken home by a responsible adult and will not be able to work for the rest of the day.