[DYSPHAGIA] Blue dye.

[LOBSTERPAM@aol.com (LOBSTERPAM@aol.com)]

At our hospital, the pharmacy provides a vial merely labeled "blue food dye." 
 It is intended for single patient use, but not single administration.  It is 
used for dyeing tube feeding to check for aspiration of reflux as well as 
p.o. attempts for dysphagia evaluations.  To my knowledge they are not using 
glucose monitoring strips although the concept makes a lot of sense to me.

In my practice, I tend to use the blue food dye for 1-3 sessions before just 
relying on observing for overt evidence of food or liquid in the secretions.  
 Interestingly, I had a FEES study completed on myself for a class I am 
teaching, and the SLP dyes the items green.  (SLP's cannot do FEES 
independently in PA at present.)  Red would be a color I never would have 
considered for a dysphagia evaluation.  A slight blue tinge would be far more 
obvious and telling to me than a slight red tinge.  As the test is not 
foolproof to begin with, I personally would hesitate to use a color that the 
body might produce anyway, especially if it were the first 1-2 times I had 
seen the patient.  Frank, copious aspiration would be evident, but trace?  
And for a pt who was already compromised from a respiratory standpoint, I'd 
want to be much more cautious.  ESU, you'll hear all this again later...   
Comments from the list are more than welcome.

And, also with hat tipped to Irene, none of these observations do anything to 
offset those cases of pneumonia which were caused or hastened by poor oral 
care.  This is a major issue in both acute and long term care, and staffing 
patterns (largely related to reimbursement) do nothing to support the care 
needs of these patients.  

As usual, my two cents.

Pam Smith, Ph.D.
Asst. Professor, East Stroudsburg University
Speech/Language Pathologist, Lehigh Valley Hospital, Allentown, PA

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