[Dysphagia] Cited reference

[lobsterpam at aol.com (lobsterpam@aol.com)]

Ali.Kutner@healthsouth.com wrote:

[[ I feel most SLP's utilize the VFSS to do exactly that - identify 
abnormalities
of swallowing physiology so we may make an appropriate plan.  If we all 
had the
"misguided tendancy" to simply ID aspiration, we would have one line 
reports:
yes no  (check one)]]

I have survey data that refute this... over 80% of the SLPs who 
responded to a survey in 2004 either "agreed" or "strongly agreed" that 
the VFSS is used to confirm the presence or absence of aspiration.  
Close to 75% either "agreed" or "strongly agreed" that patients who 
aspirated thin liquids on VFSS should be recommended to receive thick 
liquids.  Over 70%  either "agreed" or "strongly agreed" that patients 
who aspirated thin liquids on VFSS should not receive regular 
consistency water.

For nurses, the agreement for the liquid recommendations is even 
higher, probably because SLPs have inserviced them about it.

These data suggest a reliance on the VFSS to answer the aspiration 
question, and suggest  a reliance on that single piece of information 
to make recommendations.

My speculation is that our field has developed standards of care before 
there was empirical evidence to support those standards.  There IS 
evidence from the medical literature that prandial aspiration and 
pneumonia do not have a direct cause-effect relationship.  But in order 
to implement evidence based practice(using the medical evidence), SLPs 
find themselves having to "violate standards of care."

Pam Smith