Category: Assessment
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Measuring Outcomes for Success…..What are You Using?
The Dysphagia Toolbox offers valuable tools for dysphagia assessment and treatment. Various free outcome measures like questionnaires and screening tools support clinicians in evaluating patients effectively. These assessments track progress and ensure reliable evaluations, which are essential for optimal dysphagia management and documentation in compliance with healthcare standards.
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How Cognition Influences Swallowing Safety
Cognition significantly influences swallowing abilities, with cognitive decline leading to increased risks of aspiration and malnutrition. A clinical case illustrated that normalizing sodium levels improved swallowing function. Studies show that cognitive assessments predict aspiration risks, highlighting the importance of screening patients’ orientation and command-following before dysphagia evaluations to ensure safety in oral intake.
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Post-Extubation Dysphagia: What the Evidence Tells Us
What happens to the sensory aspect of the swallow with extubation? What should we expect with patients that have intubation for more than 48 hours?
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Compensatory Techniques
Compensatory strategies aid individuals facing swallowing difficulties, such as aspiration or mastication issues, by altering swallowing mechanics. Techniques include specific maneuvers and postures designed to improve swallow efficacy. While some strategies offer short-term solutions, others may provide lasting benefits, warranting assessment for effectiveness during instrumental evaluations.
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Advocating for Instrumental Assessment
Many speech-language pathologists (SLPs) forgo instrumental assessments for dysphagia due to lack of access and facility policies. This can lead to misdiagnosis and increased healthcare costs. Advocating for instrumental evaluations is crucial, as they can reduce unnecessary dietary modifications and rehospitalizations, ultimately improving patient outcomes and saving money.
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What the Heck is the MBSImP?
The Modified Barium Swallow Impairment Profile (MBSImP™) standardizes the interpretation of Modified Barium Swallow Studies (MBSS) through a clear, evidence-based protocol. Developed by Dr. Bonnie Martin-Harris, it focuses on assessing and treating dysphagia by quantifying impairments, guiding rehabilitation, and enhancing clinical understanding of swallowing dysfunction.
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Laryngeal Palpation in Swallowing Evaluations: Feel It to Believe It?
As the patient swallows, the SLP feels for hyolaryngeal movement to judge the speed and completeness of elevation. It’s a technique that’s been around for a while—but how reliable is it?
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Cervical Auscultation
Cervical Auscultation (CA) uses a stethoscope to listen to swallow sounds, aiding in assessing swallowing and airway function. However, a systematic review reveals insufficient reliability and validity for diagnosing dysphagia in adults and children. CA should not be a stand-alone diagnostic tool, as sound patterns do not consistently correlate with physiological events.
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Go With the (Peak) Flow
Insurance companies prioritize objective data, making it vital to incorporate measures like Peak Expiratory Flow (PEF) in Clinical Swallow Evaluations (CSE) to assess cough strength and airway protection. PEF demonstrates a strong correlation with aspiration risks, thereby enhancing dysphagia management through reliable and quick assessments, allowing for better documentation and therapy tracking.
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The Yale Swallow Protocol
The Yale Swallow Protocol, based on the 3-Ounce Swallow Test, provides a quick screening method for dysphagia, focusing on cognition and oral motor function. Administering involves giving a patient three ounces of water to drink while observing for signs of aspiration. This tool is easy to teach, though not suitable for all patients.
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