[Dysphagia] Hypodermoclysis

[jfurstoss at acmedctr.org (Furstoss, Jeanne ACMC)]

In Swallowing Eval Recommendations, I may write: "Consider hypodermoclysis."

I am not aware of situations in my Acute Medical Center where physicians
have followed through writing such an order, though some have asked me about
it and I have offered articles. I see this as important advocacy for
alternatives and an attempt to contribute to the knowledge base of Physician
consideration.

Jeanne Furstoss MS OTR/L SWC



-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of lobsterpam@aol.com
Sent: Sunday, February 05, 2006 10:08 AM
To: Drirenect@aol.com; dysphagia@b9.com
Subject: Re: [Dysphagia] Hypodermoclysis


Good point - but I don't recommend PEG tubes per se. This is probably 
going to sound like quibbling with semantics, but here goes.  I might 
recommend that an alternative route of nutrition be considered.  What 
type, if any, is utilized, is a medical decision - and has to be, 
because there may be other issues with that patient that might preclude 
some medical procedure that I might think would be appropriate. 
Similarly, I can comment that a patient's swallowing status places him 
at risk of dehydration, but I won't say "Recommend D5 normal saline via 
IV."  I would recommend "consider neurological workup," not "CT scan 
without contrast."  Or I would recommend that pharmacy "evaluate 
medication regime," not suggest changing a certain medication.  I know 
an SLP who made recommendations for vent settings... didn't go over 
well at all, which is no surprise.

I think at times it IS a blurry line, and there might be settings where 
an SLP has the knowledge and experience where he/she is making more 
medically specific recommendations than are others.  I know there were 
certain physicians who wanted more specifics from SLP recommendations 
than did others.

ps


-----Original Message-----
From: Drirenect@aol.com
To: LOBSTERPAM@aol.com; dysphagia@b9.com
Sent: Sun, 5 Feb 2006 10:59:10 EST
Subject: Re: [Dysphagia] Hypodermoclysis

    Actually, Pam, I think SLPs are making medical recommendations all 
the time
- What about NPO? PEG? These are purely medical.
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