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FW: [DYSPHAGIA] Blue dye test



Ann,

While I was being trained in FEES the question of will the blue food dye be 
seen in the trachea of normals came up.  I being the eager (i.e., stupid) 
trainee was volunteered to drink from one to two ounces of straight food 
coloring every 30 minutes and then get scoped 30 minutes later (for about 4 
rounds as I recall).  The hypothesis was that with respiration there would be 
blue seen in my trachea.  In between I was seeing patients throughout the 
hospital and after about the third strange look that I got I finally asked 
what are you staring at?  The patient responded "Your teeth are blue"!  There 
was never any blue found in my trachea.  You can argue amongst yourselves 
over whether I am "normal" or not.  

The Evan's modified blue dye test is a poor test to look for aspiration as 
there is a high incidence of false negative and delayed aspiration can be 
aspiration of reflux or aspiration of any retention.  
 
You just can't tell what is going on unless you look.

David M. Zirlen, M.S., C.C.C.
Speech-Language Pathologist
Zirlen & Zirlen Speech Pathologists
Chester, CT
Waterbury Hospital
Waterbury, CT



In a message dated 3/6/01 10:10:44 AM Eastern Standard Time, 
AWallace@echd.org writes:

<< This is why I asked the question.  It seems to me that if blue dye can mix
 with saliva and be aspirated in swallows of our own secretions (that's what
 I was calling "osmosis"), then the blue dye test would be no good at all
 because we would suction blue dye later from everyone.  This particular
 patient had had quite a lot of blue dyed thin liquid - maybe half a cup -
 spoonfuls followed by drinking from the cup followed by the straw - with no
 blue dye suctioned at the time.  So basically, it seems to me that the blue
 dye test is just a test of overt/frank aspiration at the time of the swallow
 only.  Right?
  
 Ann >>


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