[Dysphagia] MBS results

[v.cooper at sbcglobal.net (v.cooper)]

I am trying to get feedback from others who do MBSs regularly.

I work in a SNF. I referred an NPO brainstem stroke pt to acute for mbs. She came back w/recommendation for pureed w/thin liquid diet, and a statement to "leave the GT in for a week to assess tolerance" No therapy recommended. Results showed an 8 sec swallow delay and significant pharyngeal pooling but "no penetration or aspiration". I did bedside eval and found resident to be coughing severely after 5-6 tsp of pureed and 2-3 tsps of thin from spoon. She was clearly in distress. 

Family is very upset because ST at acute told them that she did "Great" and was ready to have the tube d/cd. Then I tell them that she does not appear safe. When they saw her coughing themselves, they believed me.

Do others make such recommendations based on what I consider to be not so great MBS results? Please advise

Thanks,

Virginia Cooper