Dysphagia Assessment Flashcards
What factors would you consider prior to conducting a swallowing assessment?
Alertness/sleepiness, variability, baseline
What are some of the factors you would consider in your initial assessment/observation of a patient?
Posture, alertness, secretions, respiratory stability
What is the aim of the Timed Water Test?
To pick up on early onset dysphagia prior to overt symptoms (i.e. you do it with someone who hasn’t been identified as having dysphagia - e.g. Parkinson’s patient)
How do you do a Timed Water Test?
Give the patient a standard sized up with 150ml of room temperature water. Ask them to swallow as quickly as possible within compromising safety. Count the number of swallows and measure the time required to swallow all the liquid. Then calculate the swallow performance ratio.
What are the main things you would do after a clinical assessment?
Reflect Establish key finding and what they mean Consider QOL and safety with the team Write detailed notes Update bedside information
Why is alertness important?
Assessment is interactive and requires patient participation
Why is a tracheostomy important with regards swallowing?
May affect upward movement of the larynx required for swallowing and could irritate the trachea
Why is respiratory functioning important for swallowing?
Difficulties with respiration could impact on patients energy levels and wearing an oxygen mask could affect swallowing
Why is posture important in swallowing Ax?
Provides information about the patient’s muscle strength/tone and potential ability to swallow
Why is oral hygiene important?
It impacts on oral phase of swallowing (e.g. mastication and bolus formation) and oral bacteria can cause infection if aspirated
How does CNV (trigeminal) impact on swallowing?
Affects sensory feedback for speech and swallowing, and innervates muscles for chewing
How does CNVII (facial) affect swallowing?
It affects sensory feedback for taste and controls secretion of saliva
How does CNIX and X affect swallowing? (Glossopharyngeal and Vagus)
Innervates muscles of tongue, palate, pharynx and larynx
How does CNXI (accessory) affect swallowing?
Innervates muscles that aid in respiration
How does CNXII affect swallowing?
Innervates tongue muscles
