Bronchoscopy Consent 🫁
Consent guide for bronchoscopy (respiratory endoscopy). Procedure explanation, risks, benefits, alternatives, and patient information for obtaining informed consent.
🔍 Procedure
- Bronchoscopy – direct visualisation of the tracheobronchial tree using a flexible or rigid endoscope inserted via the nose or mouth.
💡 Indications
- Investigation of persistent cough, haemoptysis, or abnormal chest imaging
- Diagnosis of suspected lung cancer or infection
- Foreign body removal or airway obstruction evaluation
- Bronchoalveolar lavage or tissue biopsy
- Evaluation and sampling of known or suspected lung pathology using techniques such as BAL, brushings, biopsies, or needle aspiration
🧾 Procedure Walkthrough
- Performed under conscious sedation with local anaesthetic to nose/throat.
- A flexible or rigid bronchoscope is inserted via the nose or mouth into the tracheobronchial tree.
- Visual inspection is followed by diagnostic procedures if indicated: washings (BAL), brushings, endobronchial biopsy, transbronchial biopsy, or needle aspiration.
- Procedure duration is typically 15–30 minutes.
- Post-procedure monitoring includes vitals, oxygenation, and return of gag reflex. CXR if biopsy performed.
⚠️ Risks & Complications
- Common (>5%): Low oxygen levels (may require supplemental oxygen), collapsed lung (pneumothorax) possibly requiring chest drain and longer hospital stay, especially after trans-bronchial biopsy or brushings. Obese patients have increased risk of infection, heart/lung complications, and thrombosis.
- Uncommon (1–5%): Heart strain or arrhythmias, nasal or post-biopsy bleeding (especially with anticoagulants), asthma-like bronchospasm managed with inhalers.
- Rare (<1%): Laryngospasm (brief narrowing of vocal cords), fever (usually self-limiting with paracetamol), death (very rare).
💬 Common Patient Questions
- Will I be asleep? — You’ll be sedated and made comfortable but usually remain semi-awake.
- Will it be painful? — It may be uncomfortable, but local anaesthetic and sedation reduce this.
- Can I go home after? — Usually, yes — once fully recovered from sedation.
- Will I be able to eat afterwards? — Yes, after your gag reflex has returned (typically ~1 hour).
- Will I be able to talk afterwards? — Yes, but you may feel hoarse for a short while.
✅ Benefits
- Direct visualisation of airways and access for diagnostic sampling
- Early detection and investigation of lung pathology
- Minimally invasive with quick recovery
🔄 Alternatives
- CT chest – useful for visualising anatomy but not suitable for sampling
- Sputum culture/cytology – less sensitive
- No investigation – not typically recommended due to diagnostic delay
🧠 Special Considerations
- Check coagulation status and anticoagulation – may need to pause DOACs/warfarin
- Ensure recent imaging available (e.g. CT chest)
- Assess for allergies (especially to local anaesthetic or sedatives)
- Nil by mouth 4–6 hours pre-procedure
- Post-procedure chest X-ray if biopsy or deep sampling performed to rule out pneumothorax
- Ensure interpreter or cultural liaison if communication barriers present
🗣️ Example Consent Script
- "We are recommending a bronchoscopy to examine your airways and possibly take samples to help with diagnosis."
- "You’ll receive sedation and numbing spray, and we’ll pass a thin camera into your lungs via your nose or mouth."
- "Risks include sore throat, coughing, mild bleeding or rarely more serious problems like lung collapse."
- "You’ll be monitored afterwards and can usually go home the same day. Do you have any questions?"
External resources
Educational reference only. Medical disclaimer