[DYSPHAGIA] MBS protocol

[Notweakin@aol.com (Notweakin@aol.com)]

  When I do a MBS, I choose the texture I start with based upon the 
observations made during the bedside evaluation. If I saw a substantially 
delayed swallow, I would start the MBS with thicker textures first. If I saw 
multiple swallows and/or delayed cough after puree or thick trials, I would 
start with thinner textures, as not to "plug" the valleculae and possibly 
show aspiration of a less viscous texture that might have been safe if this 
reservoir were available. Or perhaps the swallow is a bit delayed and there 
are inconsistent double swallows, I might start in the middle with semi and 
runny puree. Then choose to increase or decrease the viscosity accordingly. 
   Those are my general "rules of thumb." It never ceases to amaze me how 
often the dysphagia therapists "educated guess" at the bedside is correct. I 
would love 
to hear how you all decide what textures to start with. Karen, OTR
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