[Dysphagia] Cited reference

[DRolfe at nsccahs.health.nsw.gov.au (Deanna Rolfe)]

Given this information, I'm glad to know that our service here uses VFSS for many more purposes than just identifying aspiration...and we are educating referring doctors on the uses of the assessment too.
I'm also glad to know that our girls here take into account everything else going on with the patient (i.e. the whole picture), and discuss with the medical teams before decisions re. NBM or thickened fluids are made...and if the patient is cognitively able to make their own decisions, they are given that opportunity.

I'm sure there are many others out there who use VFSS for more than just aspiration identification. I personally think it would be a huge waste of time and energy just to get a person down to radiology, to then only look at whether they aspirated or not. With all the other information it can provide, would people really only do that?

I don't know what the wording of the question was for the survey talked about below, but if it said that VFSS was "ONLY" used for identification of aspiration, then I would be appalled at afifure of 80% believing that.
But if it didn't specify the "ONLY" then I can understand the figure of 80% (and am wondering why not higher)...as you can identify aspiration via MBS (although granted it is only a snapshot, so you may not see it on that occasion).

What country was the survey done in? (for interest sake)

Deanna

>>> <lobsterpam@aol.com> 13/01/2006 1:52:37 PM >>>
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 
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