Flexible bronchoscopy

This page explains about a flexible bronchoscopy and what to expect when your child comes to Great Ormond Street Hospital (GOSH) to have this procedure.

A bronchoscopy is a procedure that allows the doctor to look inside your child’s airway (trachea and bronchi).

During the procedure, the doctor may also take a biopsy (small sample of tissue) or wash out secretions. The secretions will be sent to the laboratory to look for infection.

In general, a bronchoscopy is used to work out what is causing breathing problems, but it can be used after an operation to the trachea, bronchi or lungs to check that they are healing well.

Information about how to prepare your child for the bronchoscopy is included in your admission letter. Your child should not have anything to eat or drink for the time mentioned in the letter. It is important to follow these instructions otherwise your child’s operation may have to be delayed or even cancelled.

The doctors will explain the procedure in more detail, discuss any worries you may have and ask you to sign a consent form. An anaesthetist will also visit you to explain about the anaesthetic. The choice of the method of going to sleep depends on many factors including your child’s condition, previous experiences and preferences.

If your child has any medical problems such as allergies, please tell the doctors.

Your child will have the bronchoscopy under general anaesthetic. The doctor will pass a bronchoscope (a thin, flexible tube with a bright light at the end) down into your child’s airway. He or she will then be able to examine the airways closely and perhaps take a biopsy. 

If a biopsy is taken, your child may cough up small spots of blood following the procedure. Blood spotting may occur up to 72 hours after the test. If your child starts to cough up large amounts of bright red blood or clots, please ring the hospital or your family doctor (GP) as soon as possible. Occasionally a child may experience a fever, which usually settles quickly with paracetamol.

Every anaesthetic carries a risk of complications, but this is small. Your child’s anaesthetist is an experienced doctor who is trained to deal with any problems that arise. After an anaesthetic some children may feel sick and vomit. They may also have a headache, sore throat or feel dizzy. These side effects are usually short-lived and not severe.

Your child will wake up from the general anaesthetic in a separate recovery room. Some children wake up straightaway but others may sleep for another two hours or so.

About three hours after the procedure, once your child is awake and sitting up on his or her own, he or she will be able to eat and drink. Fruit squash and biscuits will be provided, but you are welcome to bring along a favourite snack.

Unless your child is sick, once he or she has had something to eat and has passed urine, and as long as no other tests are planned, the cannula will be removed and you will be able to go home.

Your child may have a sore throat for a few days afterwards, which is normal. When you get home, you should give your child pain relief medicine, such as paracetamol every four to six hours, if needed, according to the instructions on the bottle.

If, when you get home, you feel that your child needs stronger medicine, you should call your family doctor (GP) or ring the number at the end of this leaflet for over-the-phone advice. Keep this information sheet by the telephone so you can explain about the procedure.

Most children recover fully within four hours of the general anaesthetic, but they may feel sick for the first twenty-four hours. You should encourage, but not force, them to drink. You can give your child milk once he or she is tolerating clear fluids. As long as they are drinking, it does not matter if they do not feel like eating for the first couple of days.