Intro to Dysphagia Flashcards
What is dysphagia?
- Swallowing disorder that involves any one of the three stages of swallowing:
1. Oral
2. Pharyngeal
3. Oesophageal - Delay in or misdirection of a fluid or solid bolus as it moves from mouth to stomach
- Impairment of emotional, cognitive, sensory and motor acts involved with transferring a substance from mouth to stomach
- Poses risk of choking and aspiration
- Failure to maintain nutrition and hydration
Define ‘globus’
Sensation of persistent lump in throat
Physically:
- lodged item
- changes to anatomical structures
- diseases, inflammation
- reflux
Psychologically:
- stress/anxiety
What is the cause of dysphagia?
Commonly the symptom of something else
Swallow can be impacted by:
- neurological injury
-mechanical/structural alterations
- pulmonary disorders
- Iatrogenic disorders
- age
- general health
What are the three main impacts of dysphagia?
- Health impacts
- Psychological Impacts
- Economic Impacts
List some health impacts of dysphagia
- aspiration/penetration
- interference with functional oral intake and capacity
- weight loss
- malnutrition
- dehydration
- prevents safe intake of oral medication
List some psychological impacts of dysphagia
- eating and drinking is a source of human pleasure
- represents a complex condition that impacts physical, emotional and social life
- burden on everyday functioning
- decrease quality of life
Contrast aspiration and penetration
Aspiration is the misdirection of oropharyngeal contents into the larynx to below the level of the vocal folds, where as penetration is when material enters the laryngeal vestibule but does not pass below the level of vocal folds
How do you detect the presence of aspiration?
- Instrumental assessment (though may by difficult to observe trace aspiration)
- chest x-ray
- respiratory signs and symptoms
- temperature
List 2 consequences of aspiration
- inflammation of lungs and possible obstruction of airways
- aspiration pneumonia
What are the consequences of aspiration dependant on?
- nature of aspirate (chemical, physical, bacteria)
- amount of aspirate
- status of patient’s pre-morbid health
What factors influence the development of aspiration pneumonia?
- pre-morbid health
- mobility of patient
(Best predictors): - dependence of feeding
- dependence for oral care
- number of decayed teeth
- tube feeding
- more than one medical diagnosis
- number of medications
TRUE OR FALSE: dysphagia alone causes aspiration pneumonia
FALSE! Not necessarily
List aspects of the SP role in dysphagia
- assessment of oral and pharyngeal stage swallowing disorders
- diagnosis of oral and pharyngeal swallowing disorders
- treatment of oral and pharyngeal stage swallowing disorders
List a) some ethical dilemmas involved in SP practice in the dysphagia space, and b) how these can be managed.
a)
- issues with compliance recommendations
- treatment may not go to plan
- refusal of treatment
- negotiating treatment (safety)
b)
- Code of Ethics
- SPA clinical guidelines
- Informed consent
- EBP
- Accurate documentation
What is the SP role in dysphagia in acute care setting?
- Awareness of general medical condition
- Decision to commence oral intake/ remove non oral supplementation
- Aim to eliminate risk of aspiration
- Patient role is passive
- Mostly compensation techniques
- Daily visits
- Ongoing monitoring
