Compensatory Strategies Flashcards
3 second prep
What it is - form the bolus, count to three before swallow, can be prompted by someone else
Why you do it - to increase control of the bolus
Stage - Oral
Alternate liquids/solids (wash down)
What it is - alternating liquids and solids
Why you do it - clears the oral cavity, prevents post swallow aspiration and residue
Stage - Oropharyngeal
Rate of intake
What it is - eating at a steady pace
Why you do it - gives plenty of to form and swallow bolus before next one, stop fatigue
Stage - oropharyngeal
Bolus placement in oral cavity
What it is -
Why you do it -
Stage - oral
Cued swallow
What it is - having someone else prompt swallow
Why you do it - keeps a steady pace, make sure bolus is effectively formed
Stage - oral
Chin tuck
What it is - tucking in chin
Why you do it - prevents premature spillage by keeping bolus forward, widens vallecular space and protects airway by tucking larynx under tongue base
With delayed swallow onset or premature spillage and decreased tongue control
Stage - pharyngeal
Head rotation & head tilt
What it is - turning head to weaker side
Why you do it - directs food/fluids down stronger side
Stage - pharyngeal phase
Neck extension
What it is - chin to sky
Why you do it - there is widening of laryngeal vestibule and narrowing of valleculae, leading to decrease in upper esophageal sphincter relaxation (which prevents reflux)
Ensure good airway protection
Stage - pharyngeal
Double swallow
What it is - swallow twice
Why you do it - clears residue in oral cavity. If mouth is not clear from one swallow
Stage - oral
Effortful swallow
What it is - squeezing muscles, increased pressure on bolus by swallowing and pushing with sufficient force. Imagine swallowing a golf ball. Can use mirror. Take breaks.
Why you do it - improves tongue base retraction. Can be tiring. Reduces residue in valleculae
Stage - oral pharyngeal
Suck swallow
What it is - contract muscles in mouth to collect and form bolus and then swallow
Why you do it - reduce oral residue
Stage - oral
Dump and swallow
What it is - place bolus at back of oral cavity
Why you do it - for someone who has had tongue removal
Stage - oral
Supraglottic swallow
What it is - 1. Take a deep breath, 2. Take a small bite of food or liquid, 3. Swallow while holding breath, 4. Cough right after swallow, 5. Swallow again
Why you do it - fills lungs with air, closes vocal folds, cough clears larynx and eliminates any aspirated material.
Used when reflexive airway is impaired
Stage -pharyngeal
Supra-supraglottic swallow
What it is - 1. Take a breath, 2. Bear down (hold breath tight), 3. Small bite of food/liquid, 4. Swallow hard (keep holding breath and bearing down), 5. Cough right after swallow, 6. Swallow again
Why you do it - used for patients who have additional pharyngeal weakness
Stage - pharyngeal
