The clinician's place for dysphagia awareness, evidence-based practice and information.
Cognition can impact many facets of life including swallowing. Patients may be confused enough that they don't "recognize" food in their mouth and effectively may not know what to do with that food. For example, when I was working in the acute care hospital, I evaluated a patient in the ICU that had sodium levels [...]
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?
Extubation is a hot and heavy topic. Determining the right time to evaluate a patient is critical in the management of these patients.
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 [...]
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 [...]
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 [...]
MBSS VS. FEES Whenever you read the literature, you often see MBSS vs. FEES or a similar thought comparing the two tests, attempting to find the superior, gold standard assessment. On social media, we seem to have 2 camps. Team MBSS and Team FEES. You can't be friends and in separate camps!! (Completely joking here!!!) [...]
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 [...]
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) [...]
It seems that everywhere we go, there are myths that are associated with FEES. There is always that reason that "I just prefer the MBSS." It may be because the MBSS has been performed in your area for much longer than FEES, but there are always other reasons heard on the street. So, here we [...]