[Dysphagia] gag reflex

[Paula.Leslie at newcastle.ac.uk (Paula Leslie)]

De nada.

There are a couple of other papers but The Lancet has a big impact on people's 
beliefs.

I also tell drs and students that you may as well assess the knee jerk reflex 
and see if that helps with the swallow too.  This seems to get the point 
across and they remember it (for those who realise I'm joking....)

Paula


>===== Original Message From "Buckie,Marcia" <mbuckie@dmc.org> =====
>oooh, thank you for this. I remembered something out there about this. 
Sometimes our interactions with residents/ med students are so rushed..just 
getting them to understand what we do is hard, and the gag issue comes up all 
the time, more so with the med students.
>
>Marcia
>
>-----Original Message-----
>From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
>Behalf Of Paula Leslie
>Sent: Tuesday, January 25, 2005 10:11 AM
>To: dysphagia
>Subject: RE: [Dysphagia] gag reflex
>
>
>Absolutely education - if we don't do it no one will.  This is the paper I
>routinely wave at our drs - in The Lancet by one of their own.  It must be
>said that some drs do actually test pharyngeal sensation which is a different
>matter of course.
>
>
>Paula
>
>
>Author
>Davies, A E; Kidd, D; Stone, S P; MacMahon, J.
>
>Institution
>University Department of Geriatric Medicine, Royal Free Hospital School of
>Medicine; University Department of Clinical Neurology, National Hospital for
>Neurology and Neurosurgery, London, UK; Department of Respiratory Medicine,
>Belfast City Hospital.
>Correspondence: Dr D Kidd, Neurology Department, St Thomas' Hospital, London
>SE1 7EH, UK.
>
>Title
>Pharyngeal sensation and gag reflex in healthy subjects.[Report]
>
>Source
>Lancet. 345(8948):487-488, February 25, 1995.
>
>Abstract
>The gag reflex is often used in the assessment of swallowing, yet its absence
>does not predict aspiration in acute stroke.Disordered pharyngeal sensation
>has been found to be a sensitive predictor. The occurrence of gag reflex and
>pharyngeal sensation in healthy people is unknown. We studied these tests in
>140 healthy subjects (half elderly and half young). Gag reflex was absent in
>37% of subjects whereas pharyngeal sensation was absent in only 1. The 
results
>largely explain the low predictive value of gag reflex in the assessment of
>aspiration in acute stroke. Testing pharyngeal sensation would be more likely
>to be useful in these circumstances.
>
>
>
>
>>===== Original Message From "Staci Otto" <otto@email.chop.edu> =====
>>I am finding that alot here- but once I share some of the literature (we've
>made lots of copies of a few articles since this keeps coming up) as well as
>my clinical assessment I feel I am making small strides towards education
>about this... at least in my small hole of the world.  suprising that med
>schools are still teaching that when there is research out there... well i
>guess not really that surprising.  :)
>>
>>Staci Otto MS CCC-SLP
>>Children's Hospital of Philadelphia
>>215-590-7959
>>
>>> "Irene Campbell-Taylor" <eripley@yahoo.com> 01/25/05 9:16 AM >>>
>>Medical schools still teach tat gag=swallow. Maybe it's time to do some
>concerted education.
>>
>>christabel daley <dysphagia@sbcglobal.net> wrote:To revisit an old
>subject........ I am familiar with the literature re the lack of relationship
>between gag & swallowing efficacy. I had a doctor recently comment on a pt 
who
>presented with functional/unremarkable clinical evaluation, "pt does not have
>a gag, therefore would not cough during clinical evaluation". Am I missing
>something? Pt did consequently go for videoswallow per MD request to find
>results consistent with clinical evaluation.
>>Thanks.
>>_______________________________________________
>>Dysphagia mailing list
>>Dysphagia@b9.com
>>http://lists.b9.com/mailman/listinfo/dysphagia
>>
>>
>>
>>Dr I Campbell-Taylor
>>Clinical Neuroscientist
>>Exclusive Distributor:
>>www.interactivetherapy.com
>>_______________________________________________
>>Dysphagia mailing list
>>Dysphagia@b9.com
>>http://lists.b9.com/mailman/listinfo/dysphagia
>>
>>
>>
>>_______________________________________________
>>Dysphagia mailing list
>>Dysphagia@b9.com
>>http://lists.b9.com/mailman/listinfo/dysphagia
>
>Paula Leslie
>Degree Programme Director
>Surgical and Reproductive Sciences
>Faculty of Medical Sciences
>University of Newcastle
>Newcastle upon Tyne
>NE2 4HH
>UK
>T +44 (0) 191 222 6279
>F +44 (0) 191 222 8988
>http://www.ncl.ac.uk/sars/postgrad/MSc.htm
>
>_______________________________________________
>Dysphagia mailing list
>Dysphagia@b9.com
>http://lists.b9.com/mailman/listinfo/dysphagia