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 [...]

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 [...]

Modified Barium Swallow Study: Gold Standard or Old News?

Modified Barium Swallow Study:  Gold Standard or Old News?

The Modified Barium Swallow Study, no matter what name is used, has been considered a gold standard for many years in the assessment of dysphagia.   Recently there has been a lot of debate about whether the MBSS continues to be the gold standard or if FEES (Flexible Endoscopic Evaluation of Swallowing) has taken the place [...]

The Instrumental Guide to Compensatory Strategies and Maneuvers

When completing instrumental assessments, the easiest way to change the swallow is to change the diet consistency. Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques Sensory techniques Maneuvers Diet changes Remember we can often change the swallow through sensory techniques.   Steele and Miller 2010 concluded:  "Boluses of liquids [...]