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[Dysphagia] RE: Hospital savings if NO swallow studies done
- Subject: [Dysphagia] RE: Hospital savings if NO swallow studies done
- From: HFarquhar at spencerhospital.org (Heidi Farquhar)
- Date: Thu Aug 5 09:15:48 2004
Go to www.vitalstim.com and click on Dysphagia Management. They have a good
break down of statistics and, how many people suffer strokes a year and the
cost to facilities for patients who come in with recurrent aspiration
pneumonia. Hope that gives you a leg to stand on.
Heidi Farquhar M.A. CCC-SLP
Speech Language Pathologist
Spencer Municipal Hospital
1200 1st Ave. East
Spencer IA 51301
Phone: 712-264-6653
Fax: 712-264-6452
hfarquhar@spencerhospital.org
"Care You Trust From People You Know"
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-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of dysphagia-request@b9.com
Sent: Thursday, August 05, 2004 7:51 AM
To: dysphagia@b9.com
Subject: Dysphagia Digest, Vol 9, Issue 6
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Today's Topics:
1. chronic hiccups (P Clarke)
2. RE: chronic hiccups (Caroline.Johnson@med.va.gov)
3. Hospital "Savings" if NO Inpatient Dysphagia Program
(Nancy Spence)
4. Re: bite reflex (Irene Campbell-Taylor)
5. Re: chronic hiccups (Irene Campbell-Taylor)
6. RE: chronic hiccups (Irene Campbell-Taylor)
7. Re: Hospital "Savings" if NO Inpatient Dysphagia Program
(Irene Campbell-Taylor)
8. RE: Hospital "Savings" if NO Inpatient Dysphagia Program
(Neubert, Rebecca R *HS)
9. Video of sucking behaviour (rnricardonunes)
10. Re: bite reflex (wwasmith@comcast.net)
11. RE: chronic hiccups (Johnson, Caroline)
12. RE: chronic hiccups (Irene Campbell-Taylor)
----------------------------------------------------------------------
Message: 1
Date: Wed, 4 Aug 2004 13:05:54 -0700 (PDT)
From: P Clarke <pbdysphagia@yahoo.com>
Subject: [Dysphagia] chronic hiccups
To: dysphagia@medonline.com
Message-ID: <20040804200554.81084.qmail@web53507.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
Hi -
I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
pneumonia. MD orders bedside swallow. At bedside very dysarthric. Reduced
oral motor and with severe hiccups (near constant hiccups). Nursing said
that pt suffers from chronic hiccups and has had them for many years (I
assume since his old stroke). Hiccups made swallow function difficult to
assess. Curious as to tx for chronic hiccups. Suggestions?
Any suggestions,
Paul B. MS-CCC-SLP
Salisbury, MD
---------------------------------
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------------------------------
Message: 2
Date: Wed, 4 Aug 2004 15:34:21 -0500
From: Caroline.Johnson@med.va.gov
Subject: RE: [Dysphagia] chronic hiccups
To: pbdysphagia@yahoo.com, dysphagia@medonline.com
Message-ID: <F040BED4EB01D511892D0000F803474801D4E85A@VHALEXEXC1>
Content-Type: text/plain
Usually Thorazine here- I would hope that's already been tried, but I try
not to assume too much!
Caroline Johnson
Speech-language Pathologist
Lexington , KY VAMC
859-281-4972
-----Original Message-----
From: P Clarke [mailto:pbdysphagia@yahoo.com]
Sent: Wednesday, August 04, 2004 4:06 PM
To: dysphagia@medonline.com
Subject: [Dysphagia] chronic hiccups
Hi -
I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
pneumonia. MD orders bedside swallow. At bedside very dysarthric. Reduced
oral motor and with severe hiccups (near constant hiccups). Nursing said
that pt suffers from chronic hiccups and has had them for many years (I
assume since his old stroke). Hiccups made swallow function difficult to
assess. Curious as to tx for chronic hiccups. Suggestions?
Any suggestions,
Paul B. MS-CCC-SLP
Salisbury, MD
---------------------------------
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------------------------------
Message: 3
Date: Wed, 04 Aug 2004 16:37:30 -0400
From: "Nancy Spence" <Nancy.Spence@BethesdaHealthcare.com>
Subject: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
Program
To: <dysphagia@b9.com>
Message-ID: <s11110cd.001@mail.bethesdahealthcare.com>
Content-Type: text/plain; charset=US-ASCII
Periodically (and repeatedly) over many years, financial justification
for dysphagia (or other) programs comes up during the budget process.
This year, it's "What if we stop doing inpatient swallowing tests?"
(after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
I pulled out a couple of references to articles from Protocol 201
summary materials by Odderson that supported economic and quality
results from day 1 intervention with stroke patients. I recall
information on cost of aspiration pneumonia vs. prevention, but not the
references. These folks are more interested in numbers ($) than words -
who can help?
Thank you!
*********************
The information contained in this message may contain health information
that is privileged and confidential and protected from disclosure. The
transmitted information is intended only for the use of the individual
or entity named above. If the reader of this message is not the
intended recipient, or an employee or agent responsible for delivering
this message to the intended recipient, you are hereby notified that
State and Federal Law strictly prohibit any dissemination, distribution
or copy of this communication. If you have received this communication
in error, please notify the sender by replying to this message and
delete this message from your computer.
Thank you. Bethesda Healthcare System.
------------------------------
Message: 4
Date: Wed, 4 Aug 2004 15:34:52 -0700 (PDT)
From: Irene Campbell-Taylor <eripley@yahoo.com>
Subject: Re: [Dysphagia] bite reflex
To: Francesca Swift <FrancescaSwift@hmh.westsound.net>,
Naomislp@aol.com, dysphagia@b9.com
Message-ID: <20040804223452.23031.qmail@web14008.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
There is, to my knowledge, nothing similar to my CD on medications and
dysphagia that was developed precisely for this reason. The PDR and CPS are
of no use in this respect - nor is the pharmacist. The CD came from a
request to write a teaching article for pharmacists because they do not know
the literature or how to interpret side effects such as "ataxia" as being
related to swallowing dysfunction.
Irene.
Francesca Swift <FrancescaSwift@hmh.westsound.net> wrote:
Do any of you know of a good, easy to use "PDR like" reference, either
a book or online, that sorts medication by class and side affects. I
have such a hard time keeping up with all of the new medications, drug
interactions and which and how they affect swallowing. I usually end up
having to run to the pharmacist as a reference. I really need book form
as we do not have a CD ROM on our work computer.
Francesca Swift, MA/CCC
Harrison Hospital
Bremerton, WA
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 5
Date: Wed, 4 Aug 2004 15:36:32 -0700 (PDT)
From: Irene Campbell-Taylor <eripley@yahoo.com>
Subject: Re: [Dysphagia] chronic hiccups
To: P Clarke <pbdysphagia@yahoo.com>, dysphagia@medonline.com
Message-ID: <20040804223632.34994.qmail@web14004.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
Tsp refined white sugar on the tongue and, no, it will have no effect on his
diabetes.
P Clarke <pbdysphagia@yahoo.com> wrote:Hi -
I have a pt with hx CVA, DM. Pt admit with pneumonia, poss aspiration
pneumonia. MD orders bedside swallow. At bedside very dysarthric. Reduced
oral motor and with severe hiccups (near constant hiccups). Nursing said
that pt suffers from chronic hiccups and has had them for many years (I
assume since his old stroke). Hiccups made swallow function difficult to
assess. Curious as to tx for chronic hiccups. Suggestions?
Any suggestions,
Paul B. MS-CCC-SLP
Salisbury, MD
---------------------------------
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Yahoo! Mail is new and improved - Check it out!
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 6
Date: Wed, 4 Aug 2004 15:37:55 -0700 (PDT)
From: Irene Campbell-Taylor <eripley@yahoo.com>
Subject: RE: [Dysphagia] chronic hiccups
To: Caroline.Johnson@med.va.gov, pbdysphagia@yahoo.com,
dysphagia@medonline.com
Message-ID: <20040804223755.60773.qmail@web14006.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
Caroline.Johnson@med.va.gov wrote:
Usually Thorazine here-
** Gosh - that's like going after a wasp's nest with a howitzer! And what
about the EPS side effects of thorazine?
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 7
Date: Wed, 4 Aug 2004 15:49:01 -0700 (PDT)
From: Irene Campbell-Taylor <eripley@yahoo.com>
Subject: Re: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
Program
To: Nancy Spence <Nancy.Spence@bethesdahealthcare.com>,
dysphagia@b9.com
Message-ID: <20040804224901.63732.qmail@web14002.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
The Odderson article included only 124 patients and made the same mistake
made by so many - the scientifically impossibility of attempting to prove a
negative. None of their patients developed pneumonia and they make the
unwarranted assumption that this was because of early intervention. This
cannot be proven! EVER. The only thing that can be proven unequivocally is
the maintenance or improvement of nutrition/hydration which is the sole
purpose of intervention in the first place.
Nancy Spence <Nancy.Spence@bethesdahealthcare.com> wrote:Periodically (and
repeatedly) over many years, financial justification
for dysphagia (or other) programs comes up during the budget process.
This year, it's "What if we stop doing inpatient swallowing tests?"
(after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
I pulled out a couple of references to articles from Protocol 201
summary materials by Odderson that supported economic and quality
results from day 1 intervention with stroke patients. I recall
information on cost of aspiration pneumonia vs. prevention, but not the
references. These folks are more interested in numbers ($) than words -
who can help?
Thank you!
*********************
The information contained in this message may contain health information
that is privileged and confidential and protected from disclosure. The
transmitted information is intended only for the use of the individual
or entity named above. If the reader of this message is not the
intended recipient, or an employee or agent responsible for delivering
this message to the intended recipient, you are hereby notified that
State and Federal Law strictly prohibit any dissemination, distribution
or copy of this communication. If you have received this communication
in error, please notify the sender by replying to this message and
delete this message from your computer.
Thank you. Bethesda Healthcare System.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 8
Date: Wed, 4 Aug 2004 19:09:17 -0400
From: "Neubert, Rebecca R *HS" <RN2D@hscmail.mcc.virginia.edu>
Subject: RE: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
Program
To: "Nancy Spence" <Nancy.Spence@BethesdaHealthcare.com>,
<dysphagia@b9.com>
Message-ID:
<3E23EBD638D79943B1EFEFAB20714C7B0165D115@HSCSEMAIL8.hscs.virginia.edu>
Content-Type: text/plain; charset="Windows-1252"
Ouch. Well, one place to start might be the new JCAHO regulations which
place significant importance on swallowing assessment for new stroke
patients. Even if your hospital is not applying for the Stroke Center
accreditation, I would see if any of the JCAHO documents related to these
guidelines has references. Try 'googling' JCAHO and stroke. I don't have the
official name handy here at home. If you can't find them, email me back and
I'll find the info. I would also appeal to your neurologists. They tend to
be staunch supporters of what we do and may add some sway if not some
references as well.
Good Luck!
-Rebecca
-----Original Message-----
From: dysphagia-bounces@b9.com on behalf of Nancy Spence
Sent: Wed 8/4/2004 4:37 PM
To: dysphagia@b9.com
Cc:
Subject: [Dysphagia] Hospital "Savings" if NO Inpatient Dysphagia
Program
Periodically (and repeatedly) over many years, financial justification
for dysphagia (or other) programs comes up during the budget process.
This year, it's "What if we stop doing inpatient swallowing tests?"
(after doing clinicals 25 years, videos 20 years, fees/sts 3 years).
I pulled out a couple of references to articles from Protocol 201
summary materials by Odderson that supported economic and quality
results from day 1 intervention with stroke patients. I recall
information on cost of aspiration pneumonia vs. prevention, but not the
references. These folks are more interested in numbers ($) than words -
who can help?
Thank you!
*********************
The information contained in this message may contain health information
that is privileged and confidential and protected from disclosure. The
transmitted information is intended only for the use of the individual
or entity named above. If the reader of this message is not the
intended recipient, or an employee or agent responsible for delivering
this message to the intended recipient, you are hereby notified that
State and Federal Law strictly prohibit any dissemination, distribution
or copy of this communication. If you have received this communication
in error, please notify the sender by replying to this message and
delete this message from your computer.
Thank you. Bethesda Healthcare System.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
------------------------------
Message: 9
Date: Wed, 4 Aug 2004 20:41:48 -0300
From: "rnricardonunes" <rnricardonunes@uol.com.br>
Subject: [Dysphagia] Video of sucking behaviour
To: "dysphagia" <dysphagia@b9.com>
Message-ID: <I1Y4HO$3616950F5B94F7C052B9CA8B5CA78A9F@uol.com.br>
Content-Type: text/plain; charset=iso-8859-1
I have unsucessfully tried to find the video films with the
sucking movements recorded by Eishima Kazuko and refered in
the paper "The analysis of sucking behaviour in newborn
infants (1991)".
Any hint will be most wellcomed.
I am also deeply interested in the differences/similarities
of
sucking behavior (breastfeeding X nipple feeding) in terms of
physiology, images, etc.
__________________________________________________________________________
Acabe com aquelas janelinhas que pulam na sua tela.
AntiPop-up UOL - ? gr?tis!
http://antipopup.uol.com.br/
------------------------------
Message: 10
Date: Thu, 05 Aug 2004 01:34:56 +0000
From: wwasmith@comcast.net
Subject: Re: [Dysphagia] bite reflex
To: Naomislp@aol.com, dysphagia@b9.com
Message-ID:
<080520040134.26661.41118EC00006A926000068252200734076089B07039C0E9999@comca
st.net>
Content-Type: text/plain
Naomi,
To add to Irene's comments, I would use an extremely firm plastic spoon or
perhaps even better a plastic coated metal spoon (avoid metal as it can
damage the teeth when chomped on, although a too thin plastic can be bitten
in half). Place a bit of firm downward pressure on the tongue with the back
of the spoon to "announce" the presence of the bolus, this may encourage a
more normal mouth closure pattern.
Also, consult your OT and PT team members about positioning. Good
proximal trunk, neck, and limb position at mealtime may help to mitigate
the bite reflex to some extent. Good luck,
Wendy
-------------- Original message --------------
> Hi all,
> Recently evaluated MR pt with recent CVA. Now has strong bite reflex
(apparently
> new) that is interfering significantly with PO intake as well as oral
care. Some
> oral stage swallow impairment but would certainly be able to manage some
oral
> intake safely if we could bypass immediate bite. Any suggestions?
> Thanks in advance,
> Naomi
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
------------------------------
Message: 11
Date: Thu, 5 Aug 2004 07:04:05 -0500
From: "Johnson, Caroline" <Caroline.Johnson@med.va.gov>
Subject: RE: [Dysphagia] chronic hiccups
To: "'Irene Campbell-Taylor'" <eripley@yahoo.com>, "Johnson, Caroline"
<Caroline.Johnson@med.va.gov>, pbdysphagia@yahoo.com,
dysphagia@medonline.com
Message-ID: <F040BED4EB01D511892D0000F803474801D4E85B@VHALEXEXC1>
Content-Type: text/plain
My understanding is that it is given very short-term.
Caroline Johnson
Speech-language Pathologist
Lexington , KY VAMC
859-281-4972
-----Original Message-----
From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Wednesday, August 04, 2004 6:38 PM
To: Caroline.Johnson@med.va.gov; pbdysphagia@yahoo.com;
dysphagia@medonline.com
Subject: RE: [Dysphagia] chronic hiccups
Caroline.Johnson@med.va.gov wrote:
Usually Thorazine here-
** Gosh - that's like going after a wasp's nest with a howitzer! And what
about the EPS side effects of thorazine?
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 12
Date: Thu, 5 Aug 2004 05:50:35 -0700 (PDT)
From: Irene Campbell-Taylor <eripley@yahoo.com>
Subject: RE: [Dysphagia] chronic hiccups
To: "Johnson, Caroline" <Caroline.Johnson@med.va.gov>,
pbdysphagia@yahoo.com, dysphagia@medonline.com
Message-ID: <20040805125035.14528.qmail@web14003.mail.yahoo.com>
Content-Type: text/plain; charset=us-ascii
"Johnson, Caroline" <Caroline.Johnson@med.va.gov> wrote:
My understanding is that it is given very short-term.
** In some people, it can take as little as one dose.
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
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End of Dysphagia Digest, Vol 9, Issue 6
***************************************
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