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[Dysphagia] Modified Barium Swallow (MBS)



I work at a 606 bed teaching, and a 44 bed facility.  At both sites, the SLP 
does a bedside swallow evaluation first, in about 95% of all cases.  We are 
the most trained to determine whether an MBS study should be recommended. 
It is often not necessary, based on the bedside findings.  Some physicians 
think they are doing the right thing by recommending an MBS right off the 
bat (they think they are doing us a favor by just ordering it instead of 
waiting for us to ask for the order), but in my experience they are 
*completely* receptive to deferring the MBS until the bedside is done.

In-house marketing of speech services should be done annually, to let docs 
know what we do, who we treat, when to refer.  During these in-services, I 
review the protocol:  bedside first, then an MBS with the speech path 
present.

Martha



----- Original Message ----- 
From: "Karen Kerr" <speechie33 at hotmail.com>
To: <dysphagia at dysphagia.com>
Sent: Wednesday, June 06, 2007 12:48 AM
Subject: [Dysphagia] Modified Barium Swallow (MBS)


>
> At our facility we run 2-4x MBS per week. Of late we have received a lot 
> of referrals from GP which haven't been appropriate (really didn't need a 
> MBS, could have been managed at bedside). As a result the radiologists 
> have not been happy with us and we are finding it harder to arrange MBS 
> clinics.
>
> What we have considered doing as a result of this is conduct bedside 
> swallowing assessments on all patients referred for a MBS from GPs. If 
> they still require a MBS, then we will arrange it for them. If a MBS is 
> not required, we will negotiate with the GP the need for the MBS.
>
> What I was wondering is if any one has any thoughts on this? Does anyone 
> else do a similar thing? If so, what is your reasoning behind it? Also is 
> there any literature on screening prior to MBS & possibly a selection 
> criteria to assist in selecting the right patients for an MBS.
>
> Thank you in advance.
>
> Karen.
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