This information will explain the test known as a Bronchoscopy and give information about what you can expect, before and after the procedure.

What is a Bronchoscopy?

It is a test, which enables the doctor to look at the back of your child’s throat and breathing tubes (larynx and bronchi) while they are asleep. A thin flexible tube is inserted into your child’s nose and down the back of the throat into the lungs. If your child has a breathing infection at the time of the procedure in the two weeks before the appointment date, please contact the department on the number at the end of this leaflet. We would like to discuss your child’s illness and treatment with you before starting antibiotics.

Why is my child having this procedure done?

Your child may have already had a chest x-ray that did not give the doctor enough information to make a firm diagnosis. This procedure is done to give us more information to help us make that diagnosis.

• You will receive a letter from your child’s consultant’s secretary to come to one of the Children’s wards at the Royal Victoria Infirmary. It is usually Ward 7 but your letter will tell you so please read it carefully.

• Before you leave home on the morning of your child’s admission, please ring the ward on the number that is in your letter to check that there is a bed available for your child.

• You will have to starve your child of food and drink as follows. Your child should have nothing to eat and no formula milk to drink from 7.30am on the day of the procedure. Infants may take breast milk up to 9.00am. Clear fluids may be taken until 11.30am and children should be encouraged to drink clear fluids up to that time.

• When you arrive you will be met by the nurses who will show you to a bed space. Your child’s nurse will record their weight, temperature, pulse and breathing.

• Approximately one hour before your child is due to go to theatre, the nurse will put some EMLA local anaesthetic cream (magic cream) on your child’s hands/arms in preparation for the injection which makes them go to sleep.

Will I be able to go with my child to theatre?

When it is time for your child to go to theatre, a nurse will take you and your child to the anaesthetic rooms where you can stay until your child is asleep. You may then be taken back to your child’s bed space where you can wait until your named nurse is informed that your child is ready to be collected from theatre. The procedure only takes about 15/20 minutes, but your child will be away from the ward for about an hour.

What happens when my child comes back from theatre?

On return to the ward, your child may be upset and confused and they may be thirsty and disorientated. This is normal and you should try not to upset yourself too much, as your child will sense your distress as well.

On return to the ward, you will be informed when you can start to give your child a drink as whilst in theatre your child’s throat is also sprayed with a local anaesthetic that takes time to wear off. If your child uses a dummy or soother, this can be used.

Once your child is drinking they will be allowed some light food that the ward will provide.

When will I be able to go home with my child?

Your child will need to have been seen by the doctor, had something to eat and drink and acting normally for them before you will be able to go home.
Your child will be sleepy for some time after the procedure but most children should be able to return home in 3 – 4 hours.

Some children for various reasons (see below) and babies under six months will have to stay overnight. It is advisable that you do come prepared to stay overnight. It is always better to plan to stay than having to suddenly start making arrangements late in the day.

You will be able to stay with your child.

Is there any reason why we will not be able to go home on the same day as the procedure?

Discharge may be delayed if your child is:

• Still very sleepy
• Not taking diet and fluids
• Has any breathing difficulties
• Has a temperature or
• Is going to need to continue with more treatment such as medicines into a vein

However, the nurses on the ward will discuss with you any changes to your child’s discharge plans.

The consultant will have already discussed with you about the small risk of having an anaesthetic during your clinic visit.

In addition, some of the children who undergo this procedure will develop a raised temperature. The nurses will check for this and give your child the appropriate medicine. If your child’s temperature remains high, then we may suggest that you stay overnight.

Your child may also cough more than usual and for some weeks after the procedure.

Will a doctor see me before going home?

You will see the doctor before you go home who will inform you what has been found. The doctor will discuss the plan for future care and treatment with you.

Please arrange to go home by car, as it is not advisable to use public transport after an anaesthetic.

If when you go home, you feel your child is not well or you are at all worried, please do not hesitate to contact the ward you have just been discharged from. They will either advise you over the phone, suggest you contact your GP or may ask you to return to the ward.

Is there anything I should look for when we get home?

Your child may have a slight temperature or discomfort in their throat. If they do, you should give them a mild pain relief (what you would normally give to your child when they are in pain at home). If you would like some pain relief medication to take home with you, please tell the nurse on your admission as it may take some time for it to be delivered from pharmacy to the ward.

Your child may also cough a little more for several days and occasionally for a few weeks due to the irritation from the tube used when your child was asleep and from the procedure.

What should I do if I am worried about my child when I get home?

If you are at all worried, concerned or just have a query about your child when you get home, please do not hesitate to contact the ward at any time, day or night, or a member of the Respiratory team. The numbers are below.

We hope this information sheet has been helpful to you but is by no means a replacement for talking to either the doctor or nurse. If you would like more information or advice please contact either:

• The main switchboard for the RVI, 0191 233 6161 and ask for the ward your child was on
• Dr O’Brien’s secretary on 0191 2824888 or Dr McKean’s secretary on 0191 2820807.
• The Respiratory Nurse Specialist for Children on direct line 0191 213 7243 or 0191 233 6161 Ext 37243 or Bleep 3490. Monday to Friday, 9.00 am – 5.00 pm