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Dysphagia
Components of bedside swallow exam
Question | Answer |
---|---|
Components of bedside swallow exam | 1. Alertness of patient 2. Intact sensory and motor components of swallowing 3. Assess pt's ability to manage own secretions 4. Assess swallowing with trial bolus |
Head Tilit | To better, or unaffected side in order to push the food to that side for chewing/swallowing. |
Head Turn | To weaker or affected side in order to close off that side of the throat. |
Direct | Modification to boluses, Postural interventions (chin tuck, head tilt, head turn), and swallowing adaptations: Supraglottic Swallow (to close airway) and Mendlesohn's Maneuver (prolonging rise of larynx -increased time to form swallow) |
Indirect | Do not include use of Bolus: Cold stimulation to faucial arches (chilled dental exam mirror), reflex facilitation, strengthening/coordination movements (exercises) and positioning. |
Decrease Tonic bite reflex | Firm pressure in the middle of the tongue with back of spoon. |
Gag reflex | Press back of spoon down firmly in middle of tongue - movements should be DISTAL (tip) to PROXIMAL (back of tongue) |