Patient education: Endobronchial ultrasound (The Basics)

What is endobronchial ultrasound? — Endobronchial ultrasound, or "EBUS," is a type of imaging test. It uses a camera and sound waves to create pictures of your lungs and the inside of your chest.

The test uses a tool called a "bronchoscope." This is usually a thin, flexible tube with a camera on the end. It is inserted through your nose or mouth to see into your windpipe and lungs. With an EBUS, the tip of the bronchoscope also has an ultrasound probe. This probe uses sound waves to create images of the inside of your lungs and chest.

Why might I get an EBUS? — An EBUS is usually done to diagnose or stage lung cancer. (Cancer staging is a way for doctors to find out how far a cancer has spread.) But it might be used to check for other lung problems, too.

Your doctor or nurse might want you to have an EBUS to:

●Check for lung cancer or see if existing cancer has spread

●Look at the lymph nodes in your chest

●Find out if your symptoms are caused by a lung problem – Examples include sarcoidosis or tuberculosis.

Sometimes, doctors combine EBUS with something called "transbronchial needle aspiration," or "TBNA." This involves taking a tissue sample from inside the lungs or chest to look at under a microscope. This can help your doctor or nurse find out more about your condition.

How do I prepare for EBUS? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

●Other imaging tests

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before your procedure. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during EBUS? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include: 

•Local – This type of anesthesia is used to numb your throat or nose, where the bronchoscope will be inserted.

•Sedatives – These are medicines to make you relax and feel sleepy during the procedure. They will also make it so you don't remember the procedure.

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, oxygen level, and heart rate during the procedure.

●The doctor will slowly insert the bronchoscope through your nose or mouth (figure 1). The camera and the ultrasound probe will send pictures to a screen that the doctor can see.

●If the doctor needs to take a sample of tissue for testing, they will use a special needle to do this. The needle is inserted through the bronchoscope.

What happens after EBUS? — After your procedure, the staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●The staff will monitor you to decide when it is safe for you to start eating and drinking again. This is because it can take a few hours for your gag reflex to return. When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

●You might have a sore throat or nose for a day or so after your procedure.

●If you had TBNA, you might cough up a little bit of blood after the procedure.

Depending on the results of your EBUS and any other tests you had, you might need more testing or treatments. Your doctor will talk to you about what happens next.

What are the risks of EBUS? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Damage to the lung or airways

●Fever – Some people get a slight fever for a short time after EBUS. This does not always mean that there is an infection.

●Low blood pressure and fainting – This could be caused by the sedative medicines. In most cases, it does not last long.

●Abnormal heart rhythm – This usually does not last long. The heart normally goes back to a normal rhythm without treatment.

●Not getting enough oxygen or trouble breathing during the procedure – If this happens, the medical team can give you more oxygen to help, or they might stop the procedure.

●A collapsed lung (if you have a TBNA)

What problems should I watch for at home? — You will likely not have any problems after an EBUS. But you should still watch for the following problems for a few days after you go home:

Call for an ambulance (in the US and Canada, call 9-1-1) if you:

●Suddenly start having trouble breathing

●Cough up a lot of blood

●Have chest pain or tightness

Call your doctor or nurse for advice if you have:

●Signs of an infection. These include:

•Fever of 100.4°F (38°C) or higher

•Chills

•Very bad sore throat

•Cough

•More sputum than usual or a change in color of sputum – Sputum is a mixture of saliva (spit) and mucus that is coughed up from the lungs.

●Cough or shortness of breath

●Very bad nausea or vomiting

●Wheezing that is not normal for you

More on this topic

Patient education: Non-small cell lung cancer (The Basics)
Patient education: Lung cancer (The Basics)
Patient education: Sarcoidosis (The Basics)
Patient education: Tuberculosis (The Basics)

Patient education: Non-small cell lung cancer treatment; stage I to III cancer (Beyond the Basics)
Patient education: Non-small cell lung cancer treatment; stage IV cancer (Beyond the Basics)
Patient education: Lung cancer risks, symptoms, and diagnosis (Beyond the Basics)
Patient education: Sarcoidosis (Beyond the Basics)
Patient education: Tuberculosis (Beyond the Basics)