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[Dysphagia] Dehydration and falls 2
Of course I can't speak for Irene, but to me her statement that
"there are multiple other variables involved" does not exclude VFSS
as a useful tool, but does not elevate it to the end-all and be-all.
Vera Karger, M.S., CCCS
Monroe, CT
vkargerslp at mac.com
On Aug 22, 2007, at 7:07 PM, Jai Gupta wrote:
> Irene said
> *** May I refer you to Groher, Logemann and others as to the fact
> that
> VFSS never shows what happens in real life. One can never say that
> one
> intervention e.g.thickened fluids, causes anything or, more
> importantly,
> prevents anything as 1) it is scientifically impossible to prove a
> negative and 2) there are multiple other variables involved.
>
> Why do we do VFSS??? If it does not give us insight into what is
> happening, Is the goal not to understand the neurophysiology and
> biomechanics of swallow and trial appropriate intervention/
> strategies??
> And see they work or not ....I find hard to swallow that a single
> episode is not sufficient to make objective, imporatant and logical
> clinical decisions...is it different to any other examinations like
> CT,
> Chest Xray or blood test....I think to me even that one
> visualization of
> swallow is always better then just observation. I do not deny that one
> cannot make with experience good decisions but we should not undermine
> the imporatance of VFSS. Caution yes ...undermine VFSS no...
>
> Jai Gupta.
> The Sutherland Hospital
>
>
>
>
> -----Original Message-----
> From: dysphagia-bounces at dysphagia.com
> [mailto:dysphagia-bounces at dysphagia.com] On Behalf Of Irene
> Campbell-Taylor
> Sent: Wednesday, 22 August 2007 23:53
> To: apdfried at juno.com
> Cc: dysphagia at b9.com
> Subject: Re: [Dysphagia] Dehydration and falls 2
>
>
>
> "apdfried at juno.com" <apdfried at juno.com> wrote: I work in acute care
> hosp. and I'm on the Falls Committee. We have researched falls
> for one
> year & the most common cause of falls is slow response to call lights
> related to needing the bathroom.
>
> *** I believe I made the point that the orthostatic hypotension
> involved in falling when getting out og bed is frequently the culprit.
> perhaps your Falls committee should look at
> hypovolemia/dehydration/falls as these have been identified multiple
> times as causing such accidents, often with lethal results. Or
> check the
> Merck Manual of Geriatrics on both falls and orthostatic hypotension.
>
> Dehydration was not listed as a cause in any of the reports we saw.
> Poor falls hx was the second largest cause since most fallers are
> repeat
> offenders.
>
> *** Indeed it is - and dehydration, among other causes, is a
> constant.
>
> As far as thickening liquids goes I definitely think more is not
> better and for years I have told students and other ST's honey
> thick is
> as bad as no liquid at all as most people dehydrate. I'm not ready
> tho
> throw out the baby however as less thick alternatives can reduce
> aspiration as clearly seen on videos
>
> *** May I refer you to Groher, Logemann and others as to the fact
> that
> VFSS never shows what happens in real life. One can never say that
> one
> intervention e.g.thickened fluids, causes anything or, more
> importantly,
> prevents anything as 1) it is scientifically impossible to prove a
> negative and 2) there are multiple other variables involved.
>
>
>
>
> Dr I Campbell-Taylor
> Clinical Neuroscientist
> Exclusive Distributor:
> www.interactivetherapy.com
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