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[Dysphagia] FYI: Neuro exam infantsandchildrenvideopresentationsonline



I should clarify my first response w/ regards to a MDs diet decision over a 
weekend if there is no SLP coverage.  If it is a pt w/ a large CVA or other 
BI that has overall decreased LOA then they will make the pt NPO or put them 
on a puree diet w/ honey thick liquids w/ 1:1 assistance.  If the pt is 
alert then they may put him/her on a soft diet and request a consult for 
Monday.

----Original Message Follows----
From: "Thompson, Elana" <EThompson@mountnittany.org>
To: <Sally.Gorski@co.hennepin.mn.us>
CC: dysphagia-bounces@b9.com, dysphagia@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam 
infantsandchildrenvideopresentationsonline
Date: Fri, 11 Aug 2006 10:36:19 -0400

My point was not about providing seven day a week coverage.  My point was 
about having either NPO status -or- a puree diet with honey-thick liquids as 
the choices of what to give a patient who has not yet been seen by an SLP.  
There are many other, and better, options for the patients.

-----Original Message-----
From: Sally.Gorski@co.hennepin.mn.us [mailto:Sally.Gorski@co.hennepin.mn.us]
Sent: Thursday, August 10, 2006 11:08 AM
To: Thompson, Elana
Cc: dysphagia@b9.com; dysphagia-bounces@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam infants 
andchildrenvideopresentationsonline



The decision was made for us regarding Sunday coverage (we have been 
providing Saturday coverage for new consults for years).  JCAHO's mandate 
regarding "one level of care" was the driving force behind the decision to 
add Sunday coverage.  That is, a patient entering the hospital on a Saturday 
afternoon (for example)  should expect and receive the same level of care 
that other patients receive Mon-Fri.  Our Neurology team also consults 
speech path on almost every patient on their service so it just made sense 
to add Sunday coverage even though we (the speech path staff) have been 
resisting this idea for years.   For many years our PT colleagues have 
provided 7 day/week including Holiday coverage and our OT colleagues added 
Sunday coverage a couple of years ago.  We're a Level One trauma center, 
teaching hospital, acute rehab, etc.  The change to Sat/Sun coverage not 
only impacted our dept, but also departments such as EEG, Cardiac Rehab, 
EMG, etc.  These are all services that the patient would typically have to 
wait until Monday morning if they were admitted anywhere between late Fri 
afternoon and Mon morning.  It's a sign of the times I think especially in 
large metropolitan facilities.  However, at this point, we are not coming in 
on the six major holidays - so we aren't here 365 days ------- yet!

Staffing Sundays is a challenge and I won't get into it in this post.






"Thompson, Elana" <EThompson@mountnittany.org>
Sent by: dysphagia-bounces@b9.com


08/10/2006 09:47 AM


To
"Irene Campbell-Taylor" <eripley@yahoo.com>, "Erin Powazek" 
<epowazek@hotmail.com>, <jsaunt@hotmail.com>, <dysphagia@b9.com>

cc

Subject
RE: [Dysphagia] FYI: Neuro exam infants andchildrenvideopresentations        
online






I was hoping to get that response from Irene since I have read it before.

I guess that is why I was wondering why the doctors at that subscriber's 
workplace would automatically make a patient NPO or put him/her on the 
puree/honey diet just because an SLP is not there for the weekend.  It 
doesn't make sense that those would be the only two solutions to having no 
weekend coverage.  It seems to me to be a disservice to the patient.

We have no weekend coverage, per say, at the acute care facility in which I 
work and the doctors will either keep a person NPO if that is called for or 
will start a diet like clear liquids or even soft regular and then will have 
the SLP eval on Monday.  We do not have an increased number of pneumonias or 
deaths by not using thickeners and puree as some sort of false safety net.

________________________________

From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Thu 8/10/2006 8:34 AM
To: Thompson, Elana; Erin Powazek; jsaunt@hotmail.com; dysphagia@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam infants 
andchildrenvideopresentations online




"Thompson, Elana" <EThompson@mountnittany.org> wrote:

                 What makes a puree diet with honey-thickened liquids safe?

                 *** Who says that it is "safe"?  What evidence is there?

                 Is there evidenced-based data that that is a clinically 
safer diet?

                 *** There are no evidence-based data in oropharyngeal 
dysphagia.





Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com

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