[Dysphagia] Project 201

[mbuckie at dmc.org (Buckie,Marcia)]

Jeanne-

I think our department did a QI study about five years back keeping
track of how often we recommended thickened liquids as a method of
managing dysphagia signs and symptoms..even then we consider it a last
resort, and mostly for pt. Comfort (We work in acute/ICU, and there are
pts that cough constantly on thin liquids, causing discomfort and
sometimes distress.

Anyway, of the monthly referrals we received I think we recommended
thickened liquids in less than 10% of our referrals. But it was not a
"STRINGENT" study, it was more for our own assessment of our practices.

In addition, the fact that thickened liquids are a negative in terms of
risk of dehydration, pt. Dislike, and if aspirated, possibly more
harmful than aspiration of thin liquids is something I was aware of.

Again, I have been working in acute care for 10+ years, so I think the
project 201 study examines a different pt. Population in a very
different setting (LTC, Parkinsons) 

Re: aspiration leading to pneumonia..we work with a pulmonogist who is
far more conservative than us in feeding patients, he makes NPO who we
have assessed to be safely and efficiently managing p.o. diet. 

Our patients are almost all immune-compromised.

Marcia

-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On
Behalf Of Furstoss, Jeanne ACMC
Sent: Wednesday, November 22, 2006 16:35
To: 'dysphagia at b9.com'
Subject: [Dysphagia] Project 201

Thanks Marcia
Any thoughts on 'thick liquids'?
Jeanne

....
Marcia wrote:On a personal/professional level,
I do and will cont. to utilize the "updated" (quotes mine) in my
clinical management of patient, in my exchanges with referring
physicians, and in training of students.

I haven't looked at this study in depth, but I have long seen the chin
tuck as the "magic bullet" by nurses, therapists and the summary that
was posted said patients who use chin tuck still got pneumonia. I wasn't
aware that was the purpose of the chin tuck..that's a pretty big leap to
make. I recommend for patients who have a lot of vallecular residue, or
tend to large pills stuck in their throat, more for comfort.

At one time, somebody told me it "helped" protect the airway, but I
haven't really found that to make sense , it often makes it worse,
depending on anatomy, nature of swallow dysfunction.

Marcia

-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On
Behalf Of Furstoss, Jeanne ACMC
Sent: Tuesday, November 21, 2006 11:55
To: 'dysphagia at b9.com'
Subject: [Dysphagia] Project 201

Colleagues,

Can we ask: what will will each of us do today to insure that benefit
(of)
utilizing widespread dysphagia intervention myths...thick liquids, chin
tuck... are agressively dispelled?

Jeanne

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