A brincoscopy is the direct inspection and observation of the larynx, trachea, and bronchi through flexible or rigid bronchoscope. Flexible fiber-optic bronchoscope allows for more patient comfort and better visualization of smaller airways and the fiberoptic scope is used more frequently in current practice. Rigid bronchoscopy is preferred for small children and endobronchial tumour resection. The purpose of bronchoscopy has diagnostic and therapeutic uses in pulmonary conditions. Diagnostic uses include

1. BRONCHOSCOPY
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Mr. ANILUMAR B R . M.SC NURSING
LECTURER MEDICAL SURGICAL NURSING

2. Description
•A brincoscopy is the direct inspection and observation of
the larynx, trachea, and bronchi through flexible or rigid
bronchoscope.
•Flexible fiber-optic bronchoscope allows for more patient
comfort and better visualization of smaller airways and
the fiberoptic scope is used more frequently in current
practice.
•Rigid bronchoscopy is preferred for small children and
endobronchial tumour resection.

3. Purposes of bronchoscopy
• Has diagnostic and therapeutic uses in pulmonary
conditions. Diagnostic uses include:
A) The diagnostic uses in pulmonary conditions:
1. To examine tissues or collect secretions
2. To determine the location and extent of the pathologic
process and to obtain a tissue sample for diagnosis (by
biting or cutting forceps, curettage, or brush biopsy).
3. To determine if a tumor can be resected surgically.
4. To diagnose bleeding sites (source of haemoptysis).

4. Purposes of bronchoscopy
B) Has Therapeutic uses in pulmonary conditions uses
include:
1. Therapeutic uses include removal of foreign bodies
or thickened secretions from tracheobronchial tree
when person can not clear them .
2. Treat postoperative atelectasis
3. Destroy and excise lesions.

5. Types of bronchoscopy
1. Fexible fiberoptic bronchoscope : The fiberoptic bronchoscope is a
thin, flexible bronchoscope that can be directed into the segmental
bronchi. Because of its small size, its flexibility, and its excellent
optical system, it allows increased visualization of the peripheral
airways and is ideal for diagnosing pulmonary lesions.
1. A rigid bronchoscope: The rigid bronchoscope is a hollow metal
tube with a light at its end. It is used mainly for removing foreign
substances, investigating the source of massive hemoptysis, or
performing endobronchial surgical procedures. Rigid bronchoscopy
is performed in the operating room, not at the bedside.
2. The examination is usually performed under local anaesthesia, but
general anaesthesia may be needed for rigid bronchoscopy.

6. Fexible fiberoptic bronchoscope

7. A rigid bronchoscope

8. Complications of bronchoscopy procedure
• Possible complications of bronchoscopy include:
1. A reaction to the local aesthetic agents.
2. Infection (if aseptic or standards precautions is not
followed).
3. Aspiration (if NPO is not implemented before a
bronchoscopy procedure.)
4. Bronchospasm and hypoxemia (low blood oxygen level).
5. Pneumothorax, bleeding, and perforation by accidental
injury during procedure .

9. Nursing and Patient Care Considerations in
bronchoscopy procedure. ( Pre procedure
interventions)
1. Before the procedure, a signed consent form is obtained
from the patient, and risks and benefits have been
explained to the patienCheck that an informed consent
form has been signed and that t.
2. Food and fluids are withheld (NPO) for 6 hours before
the test to reduce the risk of aspiration when the cough
reflex is blocked by anaesthesia.
3. Remove dentures, contact lenses, and other
prostheses.

10. Nursing and Patient Care Considerations in
bronchoscopy procedure. ( Pre procedure
interventions)
4. Administer prescribed medication to reduce secretions,
block the vasovagal reflex, gag reflex (usually atropine and a
sedative or opioid) and relieve anxiety.
5. The nurse explains the procedure to the patient to reduce
fear and decrease anxiety and encourage to the client to clear
doubts and misconceptions.
6. The nurse should be caution when administering Sedation
given to patients with respiratory insufficiency may precipitate
respiratory arrest.

11. Nursing and Patient Care Considerations in bronchoscopy
procedure. ( post procedure interventions)
1. After the procedure, it is important that the patient takes
nothing by mouth until the cough reflex returns, because the
preoperative sedation and local anaesthesia impair the
protective laryngeal reflex and swallowing for several hours.
2. Once the patient demonstrates a cough reflex, the nurse
may offer ice chips and eventually fluids.
3. The nurse assesses for confusion and lethargy in the
elderly, which may be due to the large doses of lidocaine
given during the procedure and monitor cardiac rhythm and
rate, blood pressure, and level of consciousness.

12. Nursing and Patient Care Considerations in bronchoscopy
procedure. ( Post procedure interventions)
4. The nurse also monitors the patient’s respiratory status and
observes for hypoxia, hypotension, tachycardia, dysrhythmias,
hemoptysis, and dyspnea. Any abnormality is reported
promptly.
5. The patient is not discharged from the recovery area until
adequate cough reflex and respiratory status are present. The
nurse instructs the patient and family caregivers to report any
shortness of breath or bleeding immediately.