Assessing swallowing

Question 1

Stages in screening for dysphagia

1

Answer 1

Can patient be sat up and remain awake for 15 mins?
If yes > 2
If no then nil by mouth

Question 2

2

Answer 2

Is mouth clean?
If yes > 3
If no then clean mouth

Question 3

3

Answer 3

Sit patient up and give teaspoon of water x3.
Place fingers on midline above and below larynx and feel swallow.
Are any of the signs present- absent swallow, cough, throat clearing, altered voice quality (askto say AHH)
If yes > nill by mouth and SLT refer
If no > 4

Question 4

4

Answer 4

Observepatient continuouslt drinking 1/3 glass of water
Are any of the previous signs present?
If yes > nil by mouth and SLT refer
If no > Start feeding soft options with caution. obserce for any coughing

Question 5

8 point penetration aspiration scale

Answer 5

1. mateiral doesnt enter airway
2. material enters airway, remains above vocal folds and ejected
3. material enters AW, above VC and is not ejected
4. material enters AW, contacts VC, is ejected
5. Same as 4 but not ejected
6. material enters AW, passes VC and is ejected
7. Same as 6 but not ejected despite effort
8. Same as 6 but not ejected and no effort made

Question 6

Manometry

Answer 6

catheter passed through nose into oes and pressures generated within LOS region and body of oes is measured

Question 7

Barium contrast studies

Answer 7

Swallow barium in upright and prone positions. Anatomical lesions and motility disorders investigated.
Reflux demonstrated when patient tips head down

Question 8

Test for H. pylori

Answer 8

13C urea breath test

Question 9

Asses oesophageal reflux

Answer 9

Gamma camera scan after oral technetium colliod

Question 10

Rate of gastric emptying

Answer 10

sequential gamma scans after oral technection colliod

Question 11

Gastroscopy

Answer 11

Upper GI disorders inverstigation

Question 12

Colonoscopy

Answer 12

Visualization of whole colon and ileum