[Dysphagia] MBS results

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

A Modified Barium Swallow is a moment in time.  We usually do not test for
endurance due to concern about increased exposure to x-ray as well as the
realities of time pressures for th x-ray room.  The treating clinician
should always assess tolerance and intervene as needed.  Your treatment
protocol can be based on the info from the MVS as well as your observations
during eating.   

Hilda Pressman, MA, CCC SLP BRS-S
Board Recognized Specialist in Swallowing and Swallowing Disorders


-----Original Message-----
From: v.cooper [mailto:v.cooper@sbcglobal.net]
Sent: Thursday, June 30, 2005 10:39 PM
To: dysphagia@b9.com
Subject: [Dysphagia] MBS results


I am trying to get feedback from others who do MBSs regularly.

I work in a SNF. I referred an NPO brainstem stroke pt to acute for mbs. She
came back w/recommendation for pureed w/thin liquid diet, and a statement to
"leave the GT in for a week to assess tolerance" No therapy recommended.
Results showed an 8 sec swallow delay and significant pharyngeal pooling but
"no penetration or aspiration". I did bedside eval and found resident to be
coughing severely after 5-6 tsp of pureed and 2-3 tsps of thin from spoon.
She was clearly in distress. 

Family is very upset because ST at acute told them that she did "Great" and
was ready to have the tube d/cd. Then I tell them that she does not appear
safe. When they saw her coughing themselves, they believed me.

Do others make such recommendations based on what I consider to be not so
great MBS results? Please advise

Thanks,

Virginia Cooper


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