Oral Care

Oral Care

The First Thing.... When I assess a patient with dysphagia, my first plan of attack is to teach the patient about oral care and start an oral care plan with that patient! Aspiration Aspiration is defined as the inhalation of either oropharyngeal or gastric contents into the lower airways, that is, the act of taking [...]

FEES Following Extubation

FEES Following Extubation

The 1998 Paper Leder, Cohn and Moller investigated the incidence of aspiration following extubation in critically ill trauma patients. The study looked at 20 patients who required oropharyngeal intubation for at least 48 hours.   All FEES were completed around 24 hours following extubation. Remember, aspiration is when the bolus enters the airway, below the level [...]

Why the Dye?

Why the Dye?

The many colors of FEES You've maybe witnessed a FEES exam.   It can sometimes be quite colorful. Often, green food coloring is used during the exam.   This helps to make the bolus "stand out" in the pharynx.   You may also see blue food coloring used or even white food coloring or naturally white foods such [...]

FEEST or Famine…..

FEEST or Famine…..

You know about FEES.... You've more than likely heard about FEES (Flexible Endoscopic Evaluation of Swallowing) by this time.  If not, take a look around this blog because I have been blogging about FEES all month! But have you heard about FEEST? Have you heard of FEEST?  Flexible Endoscopic Evaluation of Swallowing with Sensory Testing [...]

FEES Myth #3

FEES Myth #3

You don't use FEES.  Maybe you don't believe in FEES because you've heard somewhere that it's dangerous. Myth #3........FEES is too dangerous for my patients. I'm pretty sure that if FEES were that dangerous, it wouldn't still be a thing.  I mean, if we're doing harm to patients with use of a procedure, it would [...]

Myths of FEES Part 2

Myths of FEES Part 2

This is going to be a big one. This is going to maybe go against everything you've ever heard or known. I mean, maybe I need a drumroll here...... FEES Myth #2 Busted......... You CAN see aspiration with FEES. There.....i said it. "Good agreement was found, especially for the finding of aspiration (90%)." (Regarding FEES) [...]

The History of FEES

The History of FEES

FEES FEES (Flexible Endoscopic Evaluation of Swallowing) is a procedure to assess the swallow.   Currently, a laryngoscope is passed transnasally (through the nose) and into the upper pharynx to observe the swallow and the swallow structures through a camera.    Picture from:  www.mc.vanderbilt.edu First Description FEES was first described in the literature in 1988.   The [...]