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[Dysphagia] while we're on the topic of gag reflex...
You might want to consider the 1998 Logemann text in which she says:
-Presence or absence of gag is NOT indication of ability to swallow
-Gag reflex is triggered by noxious stimulus in pharynx; its motor
response is designed to squeeze material out of pharynx
-Swallow is set of motor actions to take food from mouth to stomach
thereby clearing noxious material from pharynx
-The cough is the reflex triggered by penetration or aspiration
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Language Pathologist, VCUMC
Adjunct Asst. Professor, Neurology
Adjunct Asst. Professor, PM&R
Asst. Clinical Professor, Otolaryngology/Head & Neck Surgery
Virginia Commonwealth University
Richmond, VA 23298
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> Since we're on the topic of gag reflex,
> I have a quick question for everyone.
> Just today I was consulted on a patient
> in ICU who has been NPO for about 8
> days now. She enterted the hospital
> with urosepsis secondary to liver failure
> from alcoholism. She also has encephalopathy
> (big suprise). Since entering the hospital,
> they found that she no longer has a gag reflex
> (I don't know how they know she had one
> before...) and they've had her on an NG tube,
> which she pulled herself yesterday. Now she
> is on TPN. They consulted me for a dysphagia
> eval and after I did it, I told the nurse that I
> thinks she would be fine to start giving small
> trials puree foods. Well, the nurse looked at
> me like I just told her she had4 heads and
> said, "you do know that she has absolutely
> no gag reflex, right?). I'm thinking to myself,
> why in the world did I get consulted if you don't
> want her to eat anyway??
>
> I did just look at those articles just posted by
> the last person about the gag. Does anyone
> else have any good information to give me
> regarding this issue or about what I could
> say to the nurse/doctor? Am I totally off
> basis here??
>
>
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>
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Language Pathologist, VCUMC
Adjunct Asst. Professor, Neurology
Adjunct Asst. Professor, PM&R
Asst. Clinical Professor, Otolaryngology/Head & Neck Surgery
Virginia Commonwealth University
Richmond, VA 23298
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