Endoscopy of the lungs and bronchi - how they do it, what kind of procedure it is

Proper preparation

Before performing endoscopy of the bronchi and lungs, the patient must remember the basic rules of preparation for the procedure:

The examination is carried out on an empty stomach. Otherwise, food or a drink will accidentally enter the respiratory tract due to an accidental cough or vomiting.
If a course of medication is prescribed, it is recommended to talk with your doctor; you may need a break for one day.

Before performing a pulmonary endoscopy, it is necessary to plan so that the last meal takes place no later than 21 hours before the start of the procedure.

Bronchoscopy

Bronchoscopy is a method of examining the mucous membranes of the trachea and bronchi using a special device - a bronchoscope. A tube equipped with lighting equipment and a video camera is inserted into the respiratory tract through the larynx. This modern equipment provides research accuracy of over 97%, which makes it indispensable in diagnosing various pathologies: chronic bronchitis, recurrent pneumonia, lung cancer.

Preparation for bronchoscopy

Before bronchoscopy, it is necessary to undergo a number of diagnostic tests:

radiography of the lungs,
ECG (electrocardiogram),
blood tests (general, for HIV, hepatitis, syphilis),
coagulogram (blood for clotting)
and others according to indications.

Dinner should be no less than 8 hours before the procedure.

On the day of the study, smoking is prohibited (a factor that increases the risk of complications).

Bronchoscopy is performed strictly on an empty stomach.

In the morning, it is necessary to do a cleansing enema (prevention of involuntary bowel movements due to increased intra-abdominal pressure).

It is recommended to empty your bladder immediately before the procedure.

If necessary, the doctor will prescribe mild sedatives on the day of the procedure. Patients with bronchial asthma must have an inhaler with them.

For people suffering from cardiovascular pathology, preparation for bronchoscopy is carried out according to an individually developed program.

Methodology

Immediately before the procedure, the doctor will ask you to sign a consent form for the manipulation. Be sure to discuss with your doctor the likelihood of consequences, as well as the risks of the examination!

The study is carried out in a specially equipped endoscopy room, where the same sterility conditions are observed as in the operating room. The procedure is performed by a doctor who has undergone special training in bronchial examination.

The duration of bronchoscopy is 30-40 minutes.

By spraying the patient, bronchodilators and painkillers are administered to facilitate the advancement of the tube and eliminate discomfort.

Patient's body position: sitting or lying on his back.

It is not recommended to move your head or move. To suppress the urge to vomit, you need to breathe often and not deeply.

The bronchoscope is inserted through the oral cavity or nasal passage.

In the process of moving to the lower sections, the doctor examines the internal surfaces of the trachea, glottis and bronchi.

After the examination and the necessary manipulations, the bronchoscope is carefully removed, and the patient is sent to the hospital for some time under the supervision of medical staff (to avoid complications after the procedure).

Feelings after bronchoscopy

Feelings of numbness, a lump in the throat and nasal congestion will persist for up to 30 minutes. During this time and after another hour, it is not recommended to smoke or eat solid food. Also, doctors do not recommend driving a car on this day, since the administered sedatives can impair concentration.

Possible complications

The risk of negative consequences, although minimal, is possible. Therefore, you should immediately consult a doctor if you notice the following symptoms:

hemoptysis for a long time;
pain in the chest;
audible wheezing;
feeling of suffocation;
nausea and vomiting;
rise in body temperature.

How is tracheobronchoscopy performed?

On the eve of the procedure, the patient undergoes an examination by a doctor. If necessary, it is possible to prescribe a sedative at night, this will reduce the level of anxiety and allow you to get a good night's sleep.
Sedative medications can be taken immediately before the start of endoscopy, but the decision remains with the doctor.
Dentures must be removed; the flexible tube of the endoscope can displace them towards the respiratory tract.
The neck should be free, so choose clothes that are loose at the top.
During the preliminary examination, it is necessary to inform if there is a history of allergic reactions to medications or products.
To ensure that the endoscope passes painlessly and a cough reflex does not occur, local anesthesia is applied to the mucous membrane of the nasal cavity and oropharynx using a sprayer.
The position during the procedure is determined by the doctor. There are two options: lying on your back or sitting on a chair.
At the end of the endoscope there is a camera that will allow the doctor to insert the instrument under visual control while simultaneously examining the lungs on both sides.
Most often, the device is inserted through the nose, but sometimes through the oral cavity.
Special forceps are used for biopsy. The procedure for taking a sample from the mucous membrane is painless and extends the time by only 1-2 minutes.

Recommendations for nursing staff on preparing a patient for endoscopic examinations.

Algorithm for preparing for bronchoscopy .

Introduction The psychological state of the patient is a fundamental condition, along with quality preparation, for safe and effective endoscopy. Thanks to the achieved positive psychological result in the examination, the feeling of anxiety before the examination and during the endoscopic examination is leveled. Communication between the medical professional and the patient before these types of examinations is of no small importance. First of all, from an emotional point of view, it is important for patients to know: what kind of doctor will examine them, his experience, qualifications, and how the examination will take place. It should be noted that modern technology for conducting endoscopic examination requires the utmost concentration of attention from the medical worker to monitor the general condition of the patient being examined and has the ability to provide him with psychological assistance in a timely manner. A medical worker at the stage of preparation for an endoscopic examination, through adequate psychological contact, has the opportunity to minimize the patient’s feeling of anxiety. The department's medical worker explains to the patient the essence of the study and the corresponding rules of behavior.

Preparation for the procedure: 1. Inform the patient that:

3-4 days before the study, it is necessary to exclude alcohol intake (as it sharply worsens the tolerability of the study and distorts the picture of the mucous membrane of the organs in question due to its irritating effect, and also strengthens the cough and gag reflexes)
on the eve of the study, the last meal at 19:00 is a light dinner (tea, broth, fermented milk products, juice, bread);
You can take medications prescribed by your doctor
the evening before the examination, you should stop smoking (nicotine increases the gag reflex and salivation, which will make breathing difficult during FEBS, and it also reduces the potency of local anesthetics used during bronchoscopy)
if you are worried before the study, then the night before going to bed you can take sedatives prescribed by your doctor or weak sedatives (valerian tablets, novopassit, etc.)
on the day of the examination - fasting, it is necessary to avoid drinking any liquids, if absolutely necessary - the last drink of water 1 hour before the examination (boiled water - no more than 100 ml)
Taking medications by mouth on the day of the examination is possible 1 hour before the examination, wash them down with a small amount of water
Less than an hour before the test, you are allowed to take medications sublingually and use an inhaler.
Patients with diabetes who regularly use insulin should skip the morning injection.
Patients suffering from epilepsy or seizures should start taking anticonvulsant medications prescribed by their doctor 2-3 days before the study. 3-4 hours before the test, you must take this drug in crushed form with a small amount of water (up to 100 ml). It is necessary to warn your doctor about the possibility of developing a seizure.
at the FBS you need to take: a towel, an outpatient card or medical history, protocols of previous studies, a referral, radiographs of the lungs, medications that you regularly use for heart pain, choking (nitroglycerin, inhaler, etc.)
Before the examination, be sure to warn the doctor performing the examination that you have serious diseases or intolerance to anesthesia drugs
Before the examination, you must unbutton your shirt collar, which may make breathing difficult during the examination.
Before the examination, as prescribed by the doctor, an intramuscular or intravenous injection of the drug is performed, after which you may feel drowsiness, a slight increase in heart rate, and dry mouth.

Figure 1. Performing bronchoscopy

Algorithm of action during the procedure: 1. Explain to the patient the purpose and progress of the study, the rules of behavior during the study and obtain his consent. 1. Provide psychological preparation to the patient. 2. Inform the patient that the test is performed in the morning on an empty stomach. He should exclude food and water the night before, and not smoke. 2. Make sure that the patient removes removable dentures before the examination. 3. Show the patient to the endoscopy room at the appointed time with a towel, medical history and a referral. 4. Irrigate the mucous membrane with 10% lidocaine spray. 5. Follow SOPs for conducting the study. 6. Take the patient to the room and warn him not to eat or smoke for two hours after the examination. 7. Inform the patient that: - after the study, do not take water or food for 30 minutes (until the feeling of a “lump in the throat” disappears), then do not consume spicy, rough food and alcohol - after the biopsy for 12- Do not consume hot food or drink for 18 hours. - after the examination, hoarseness is possible, which will disappear within a few hours.

How does the patient feel?

Bronchial endoscopy is accompanied by local anesthesia, which causes a sensation as if the nose is stuffy. First, the tongue and palate become numb, and a feeling of “lump” appears in the throat. It is difficult to swallow saliva for some time.
Modern techniques allow the procedure to be performed without pain.
The diameter of the device is much smaller than the lumen of the lungs, so endoscopy is a completely safe procedure; you should not be afraid that you will suffocate during the procedure; a specialist is responsible for the patient’s health.

Spontaneous breathing is not impaired in any way.

Preparing for a colonoscopy

Preparation for colonoscopy with MOVIPREP

If you suffer from constipation, you need to take the laxatives you usually use every day. One pharmaceutical package contains 2 sachets (sachets) A and B. To prepare the first liter of solution, the contents of one sachet A and one sachet B are dissolved sequentially in a small amount of water. Then the amount of liquid is brought to 1 liter with water. The solution is taken in fractions, approximately 250 ml per 15 minutes. To prepare the second liter of solution, repeat the procedure. After each liter of solution drunk, for any period of time, you must drink another 500 ml of the permitted liquid.

Dosage regimen depending on the time of the study

Morning colonoscopy from 8.00 to 10.00: on the day before the colonoscopy at 19.00 you need to drink the first liter of solution. Start drinking the second liter of solution an hour after finishing the first liter. When finished, drink another 500 ml of liquid.

Daytime colonoscopy from 10.00 to 14.00: on the day before the colonoscopy, from 20-21 hours, you need to drink the first liter of solution. Start drinking the second liter of solution at approximately 6-7.00 am. When finished, do not forget to drink another 500 ml of liquid.

Evening colonoscopy from 14.00 to 19.00: on the day of colonoscopy from 8-9.00 you need to drink the first liter of solution. Start drinking the second liter of solution an hour after finishing the first liter, i.e. around 10-11 o'clock. When finished, don’t forget to drink another 500 ml of liquid

Preparation for colonoscopy with the drug "ENDOFALK"

One pharmaceutical package contains 6 sachets of Endofalk. In preparation for a morning colonoscopy (up to 13:00) At 19:00 - 20:00, all six Endofalk sachets are dissolved in 3-4 liters of drinking water. The more acidic, the easier it is to tolerate (carbonated water cannot be used!) After dissolving, it is better to cool the liquid. The resulting solution should be drunk slowly, over 4-5 hours, one glass at a time over 15-20 minutes, in separate sips. In preparation for a daytime study from 13.00 to 19.00, the first liter is drunk at 20-22 hours, the second liter of solution 7-8 hours before the study. To improve the taste, you can drink it with sour juice without pulp, or eat it with lemon slices. If you feel nauseous, stop taking the drug for 30-40 minutes. Use lemon or just rest. After 1-2 hours from the start of treatment, you will have loose stools, bowel movements will be completed 2-3 hours after taking the last dose of Endofalk.

There is no need to do enemas when preparing with Moviprep and Endofalk! The patient arrives on an empty stomach!

Preparation for colonoscopy with the drug "PICOPREP" according to the morning prescription instructions

(prescribing the drug to patients over 65 years of age is undesirable)

3 days before the study you must follow a slag-free diet. If you suffer from constipation, you need to take the laxatives you usually use every day. You can also slightly increase their dose.

One pharmaceutical package contains 2 sachets of Picoprep. Immediately before use, the contents of one sachet are dissolved in 150 ml of water, stirred for 2-3 minutes, cooled and taken at 16-18 hours, washed down with at least five glasses of any clear liquid (water, tea, clear non-red juices, soft drinks . The contents of the second sachet are taken at night at 22-24 hours, washed down with three glasses of liquid. When performing a study “in a dream”, the last dose of liquid is no later than 6 hours before the study. When preparing an enema with the drug, there is no need to do an enema! The patient arrives on an empty stomach!

Preparation for colonoscopy with the drug "PICOPREP" according to the instructions for daily use

(prescribing the drug to patients over 65 years of age is undesirable)

3 days before the study you must follow a slag-free diet. If you suffer from constipation, you need to take the laxatives you usually use every day. You can also slightly increase their dose.

One pharmaceutical package contains 2 sachets of Picoprep. The contents of one sachet immediately before use are dissolved in 150 ml of water, stirred for 2-3 minutes, cooled and taken at 19-21 hours, washed down with at least five glasses of any clear liquid (water, tea, clear non-red juices, soft drinks . The contents of the second sachet are taken 5-9 hours before the study. When performing the study “during sleep”, the last dose of liquid is no later than 6 hours before the study. When preparing an enema with the drug, there is no need to do an enema! The patient arrives on an empty stomach!

Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

What can you do after bronchoscopy?

It will take about 20-30 minutes for the numbness in the throat to go away, then the patient is allowed to eat. Usually a person understands this himself when the feeling of a foreign body and cold disappears. If the endoscopy was accompanied by the collection of biological material for additional laboratory testing, then the time of meal intake is determined by the doctor.

By following the basic rules and recommendations of the doctor, the patient will not feel discomfort and will soon receive the results of the diagnostic procedure performed.

Videobronchoscopy

Videobronchoscopy is an endoscopic examination of the tracheobronchial tree. An apparatus for examining the respiratory tract (bronchoscope) is inserted through the nose and larynx into the lumen of the trachea and bronchi. The method allows you to assess the condition of the lumen, walls and mucous membrane of the respiratory tract, detect neoplasms, and perform painless collection of tissue samples (biopsy) and bronchial lavages for further study in the laboratory.

Bronchoscopy is a serious manipulation performed as prescribed by a doctor after a preliminary basic examination.
Before it is carried out, in accordance with the order of the Ministry of Health of the Russian Federation, an X-ray examination of the chest and sputum analysis for VK are required.
To avoid complications, the study is carried out strictly on an empty stomach.

In what cases is bronchoscopy prescribed?

Bronchoscopy is indicated in the following situations:

In order to clarify the diagnosis in the presence of changes identified during X-ray examination.
To identify tumors of the tracheobronchial tree when central lung cancer is suspected.
To find out the causes of difficulty breathing, bleeding from the respiratory tract, and long-term cough.
To take pieces of bronchial tissue for further laboratory study (biopsy).
For collecting mucus from the bronchi for the same purpose.
To remove foreign bodies from the respiratory tract.
For the administration of medicinal substances and sanitation (“washing”) during therapeutic bronchoscopy.

How to prepare for bronchoscopy?

Since accidental entry of food or liquid into the respiratory tract during vomiting and coughing can cause severe inflammation of the lungs, and in some cases, respiratory arrest and cardiac dysfunction, bronchoscopy is performed strictly on an empty stomach. The last meal should be 12 hours before the test.
On the day of the examination, several small sips of water are allowed at least 5-6 hours before the procedure.
If you need to take medications, consult with your doctor about your dosage schedule on the day of your bronchoscopy.
After the examination, it is recommended not to drink or eat for 1 hour.
After bronchoscopy, for about half an hour the patient still has a feeling of numbness in the throat and a hoarse voice - there is no need to be alarmed, this is a consequence of anesthesia of the vocal folds, it goes away along with the action of Lidocaine (like the feeling of numbness in the jaw after dental treatment with anesthesia).

Features of the study

Your consent to undergo bronchoscopy implies that you understand the need for this study and understand its essence. If you have anxiety and anxiety, do not be afraid to ask your doctor questions. Please tell your doctor or nurse if you have any allergies or drug intolerances; whether you have had a bronchoscopy before, whether you have asthma, and any changes in your health recently.

During the examination, anesthesia with Lidocaine will first be carried out step by step. The procedure may provoke a cough, but does not interfere with breathing or cause pain. Typically, the examination lasts about 20 minutes, but since at least half of the entire examination time is occupied by anesthesia of the respiratory tract, due to the individual characteristics of the body, it may proceed faster or longer. When the examination is completed, the bronchoscope is removed from the bronchi easily and quickly.

After research

If you experience weakness and drowsiness, stay for a while in the endoscopy department under the supervision of our staff. Because you were given anesthesia in your larynx before the test, it is not safe to take food or liquid right away to avoid possible inhalation. Your swallowing reflex will be fully restored in about 1 hour. Since the device is inserted into the bronchial tree through the nose, and the nasal mucosa is thin and vulnerable, after the examination there may be minor nosebleeds, and if a biopsy was performed, streaks of blood may sometimes be found in the sputum. This goes away within 24 hours and should not cause you concern. Rarely occurring after the study, sore throat or hoarseness of the voice will also decrease within 24 hours. If you go straight home on the day of the test, it is better for someone to accompany you. At home, try to devote the rest of the day to rest.

The anesthesia may last longer than expected, so you should not:

drive,
maintain machinery and technical equipment,
drinking alcohol.

When will I know the result of the bronchoscopy?

The doctor will inform you of the results of the study immediately. However, if to clarify the diagnosis it was necessary to take tissue or contents of the bronchi for analysis, it will take from 1 to 7 days before the final result becomes known. Details of the necessary treatment should be discussed with the doctor who recommended the study and referred you for bronchoscopy.