Bronchoscopy For Children – What To Expect by Dr. Srikanta J T

Bronchoscopy is an invasive procedure where the doctor will insert a thin tube with a camera and a light at the end. They will insert this tube through your child’s nostril or mouth and go down all the way to the lungs. This tube is called a bronchoscope.

Through this bronchoscope, the doctor will get a better look at the lungs and the air passage. They can determine the source of the problem, which is essential for a proper diagnosis. In most cases, the bronchoscope is a flexible tube that will bend and turn in your air passage without trouble.

However, if your child is experiencing any type of bleeding in their lungs or the air passage, the doctor will use a stiff tube. Even if something is stuck in the child’s air passage, a stiff tube will be used.

Do not worry, a bronchoscopy will not hurt your child or cause any pain as the lung tissue has no pain fibres. It can cause lung inflammation and coughing but the doctor will prescribe medicine for it, and it will subside in a short span of time.

What is Carried Out in Bronchoscopy For Children?

Bronchoscopy involves the following steps

1. In a bronchoscopy procedure, the doctor will sedate your child’s throat and mouth before beginning the procedure.
2. They will then insert a thin tube with a light and camera attached at the end. This tube will go through the nostrils, through the windpipe all the way to the lungs.
3. The camera helps get a closer look at the lungs and air passage.
4. In case of damage, the doctor can identify the exact spot with the help of this instrument. Bronchoscopy is the most preferred procedure to dislodge anything from the airways too.
5. The doctor will obtain some tissue or mucus samples; dislodge foreign objects from the throat (kids are notorious for putting everything into their mouth).
6. It helps to treat certain lung issues.

A doctor will perform this procedure if your child has:

• A persistent cough that is not subsiding with any medications.
• Trouble breathing.
• Has had an infection or multiple infections.
• Abnormal CT scan and X-ray that could indicate an issue.
• Swallowed something they were not supposed to, which is now lodged in their throat.

A bronchoscopy helps doctors in the following ways:

• To diagnose a problem in the lungs.
• Identify an infection in the lungs.
• Do a biopsy of the lung tissue.
• Remove mucus, tumour or a foreign object that may be blocking the airway.
• Put in a stent to hold the airway open.
• Treat lung issues like collapsed or bleeding lungs.
• Take a closer look at the lymph nodes near the lungs.

[Read : What To Do When Your Kid Swallows A Coin]

How do You Prepare a Child For Bronchoscopy?

If your child has repetitive lung infections or bleeding, your doctor will ask for a bronchoscopy. Usually, the attending doctor will only perform this test. The medical care team will give you specific instructions and prep your child for the procedure.

As a parent, it is essential that you prepare your child to go through with this procedure. It can be very difficult and scary for them. Here are some ways in which you can prepare them:

1. Intake

Do not give your child anything to eat or drink post-midnight before the bronchoscopy the next day.

2. Medications

If your child is on any medications, check with the doctor as to when you should stop their usage or if it won’t interfere with anything. Certain medications will have to be stopped days before the procedure. So make note of the duration required and stop accordingly.

3. Brief Them

Talk to your child and brief them about what is going to happen. It is after all their body and they have a right to know what is happening to them if they want to know. Tell them about the procedure and what to expect after the procedure.

4. Reassure Them

It can be scary for a child to allow someone to insert a tube into their nose. It is not a comfortable feeling either. Provide moral support and reassure them you will be close by, and they have nothing to fear.

5. Answer Questions

Your child will have several questions regarding the procedure. Even if they don’t make much sense or if the question is repeated multiple times, stay patient and answer them. They are just too scared to tell it out.

6. Meet the Doctor

If needed let your child meet the doctor who will be performing the procedure. In all probability, it will be the same doctor who has been assessing and diagnosing your child. Let them feel secure around the doctor and not fear them. This will make them cooperate during the procedure.

7. Before The Procedure

The medical care team will make note of your child’s vital readings. This can sometimes upset a child who is already in fear of the upcoming procedure. Calm them down and reassure them.

8. After The Procedure

Your child will be observed for many hours to rule out any complications. Only then will they be discharged. During this time, their throats can feel dry and numb. They need to wait until the numbness wears off, to even drink water. Inform them about this, so that they don’t start panicking and have a breakdown after the procedure.

9. Comfort Toy

If it is a small child and they like to hold on to a toy, you can give it to them. The medical care team might let them hold on to it before and after the procedure. This can be a little reassuring for them as they won’t be scared of feeling alone.

How Long Does a Paediatric Bronchoscopy Take?

The length of the bronchoscopy varies. It can last anywhere between 15 minutes to an hour. It all depends on what the issue is. If it is a simple washing, it won’t take too long. On the other hand, collecting samples or analysing the damage can take more time.

For small children, it may take some time as their airways will be very narrow and the procedure has to be done precisely. However, they cannot be put under anaesthesia for long.

Once the procedure is over, your child will be taken to the recovery room where the medical care team will closely monitor them. As your child wakes up from the anaesthesia, the staff will monitor their condition and let them go once they are fully satisfied, and the doctor verifies the same.

So, you will have to prepare your child for a “few hours” of treatment.

Are There Any Side Effects to Bronchoscopy Tests For Children?

Like any other procedure, bronchoscopy has its own set of risks. While some can be very minor, some can be more concerning but rare. Do not worry unnecessarily thinking about the side effects. If your child is suffering from a lung issue, it needs to be checked closely. Bronchoscopy is the only way to do it safely and quickly.

Some of the possible side-effects you can expect are:

• Bleeding: If a biopsy was taken, then there are chances for bleeding, however, this will stop soon on its own.
• Bronchospasm: Irritation of the airway.
• Laryngospasm: Irritation of the vocal cord.
• Infection: Does not happen regularly.

Recovery Time After Bronchoscopy For Children

Your child will need a few weeks to recover. Their throat has been invaded and checked. It will result in some hoarseness and difficulty while swallowing. Your child might find this very difficult and might have meltdowns or tantrums. Ensure you comfort them and consult the doctor if the problem persists after the recommended duration.

Your doctor will usually recommend something for hoarseness or cough. If they don’t ask them if one will be needed. Get the prescription beforehand as you may not be able to consult the doctor as and when you want. Also, you want to focus on your child’s healing. Getting things in order before the procedure can make the entire episode very smooth.

The doctor will ask your child to avoid any strenuous activities post the procedure so that they don’t strain their lungs and airways too much. Keep your child informed about this and ensure they don’t exert themselves for a few days, as recommended.

Get your child checked immediately if they experience any of these:

1. Fever that lasts more than a day
2. Pain in the chest
3. Breathing trouble
4. Coughing brings up blood

[Read : Breathing Problems In Children – Causes And Symptoms]

Ineligible For Bronchoscopy

Sometimes, a child may be ineligible for a bronchoscopy despite their lung issue. Some of the reasons that can make them unfit for the procedure are:

1. Narrow airway that is severe and blocks the trachea.
2. Very low oxygen levels – it is not advisable to administer anaesthesia to such patients.
3. If your child is coughing and gagging severely, the doctor may ask you to wait until they feel better to do the procedure.

Bronchoscopy for children is an invasive procedure though it does not involve any suturing. It is a simple procedure that won’t take much time and will help in a better diagnosis of the problem your child is suffering from. It may be scary for both you and your child, but it will be done in no time.

FAQ’s

1. What is the Most Common Reason For Bronchoscopy in Children?

One of the most common reasons for bronchoscopy in children is something obstructing their airway. It could be just mucus or something they swallowed.

2. Is a Child Awake During Bronchoscopy?

No, the child will be given anaesthesia before the procedure begins. For small issues, local anaesthesia will be given and for issues that will take a long time, general anaesthesia will be given. It also depends on the age of the child and the doctor’s usual method of treatment. The main aim here is to prevent your child from moving during the procedure and avoid any injury or damage.

3. Can a Child go Home After a Bronchoscopy?

Yes, they can. The entire procedure should not take more than an hour. However, if your child were to develop any complications or bleed after the procedure, the doctors will want to keep them overnight or longer, for observation and healing.

4. What is the Difference Between Bronchoscopy and Endoscopy?

An endoscopy is a medical procedure that involves a close assessment of the internal organs and parts of the body with a camera and light. Endoscopy is a generic term and there are several types of endoscopies for various parts of the body. Bronchoscopy is the analysis of the throat and airways that lead to the lungs.

Read Also: Lung Function Test For Children – What Can You Expect by Dr Srikanta J T