Radiation Saftey, Tx Planning, Ethics, OWL, End of Life Decision Making Flashcards
The Principle of ________ is in practice for all institutions using medical radiation.
ALARA
As low as reasonably achieveable (w/out affecting accuracy of VFSS)
Acceptable radiation doses are lower in children b/c
Children’s developing organs are more susceptible to the effects of radiation
The three most sensitive tissues to radiation:
The least sensitive:
Eyes, thyroid, upper esophagus
Skin
For SLPs the primary source of radiation during the VFSS is from:
The patient because of radiation scatter
Three basic tenets of radiation protection:
Time
Distance
Shielding
Key to tx planning
Link physiology to short term goals
Signs at Oral Prep Phase
Loses food from mouth, can’t form cohesive bolus
Signs at Oral Phase
Can’t move bolus to back of mouth
Lose bolus over back of tongue
Signs at Pharyngeal Phase
Food enters airway before during or after swallow
Food left in vallecula or pyriform sinus
Signs at Esophageal Phase
Retrograde flow causes food to enter pyriforms or airway
What is the functional ST objective and measurable approaches if the patient has food left in the valleculae?
ST: PT will reduce residue left in the valleculae that might fall into the airway
Measurable Approaches:
Compensatory: PT will use an effortful swallow/chin tuck w/without cues on ___% of trials.
Rehab exercises: PT will demonstrate TBR w/ resistance on ___ of ___ trials.
Diet: PT will avoid sticky foods with/without cues on ___ of ___ trials. Pt will only take pills crushed & mixed in pudding.
**See lecture for more ST objectives
Common long-term goal linked to ability to maintain:
Adequate hydration & nutrition on a given diet level w/ no overt difficulty or s/s of aspiration
Evidence Based Practice includes:
Current best evidence
Clinical expertise
Client values
Basic principles of medical ethics:
- PTs must be able to fully participate in decisions regarding their health care
- QOL paramount
Most common ethical dilemma in SLP
PT who aspirates refuses to use a feeding tube under any circumstance
- document recommendations/pt refusal for legal purposes
- Conversations w/ family & education received
- right to ask another professional w/ different perspective to assume care
