[Dysphagia] Practice approaches

[Jai.Gupta at SESIAHS.HEALTH.NSW.GOV.AU (Jai Gupta)]

That is a impressive record. What was the severity of dysphagia they had and comorbidity score would be interesting to analyse.

Jai Gupta. M.Sc.(S.H.) CPSP MSPA 
Manager, Speech Pathology Department 
The Sutherland Hospital 
* Locked Bag 21, Taren Point  NSW  2229 Australia
* +612 9540 7111 page 594 or Direct +612 9540 7558  
*+612 9540 7717 *+61 0401 373 324 
<mailto:Jai.Gupta@ sesiahs.health.nsw.gov.au>  

A Thought 

You see things; and you say, "Why?" But I dream things that never were; and I say, "Why not?" ...... George Bernard Shaw


 






-----Original Message-----
From: Flaksman, Chaim [mailto:flaksman at wolfson.health.gov.il]
Sent: Friday, 15 June 2007 5:52 PM
To: Jai Gupta
Subject: RE: [Dysphagia] Practice approaches


Hi
I started with the Freizer 2.5 years ago.
I have data on 107 patients, who came to our clinic, did FEESST, had
swallowing problems from various reasons), but we did intruct the
Frazer, and thank god non of them returned with pneumonia.
Just for you to know.
Nophar Ben David, SLP, M.A, Dysphagia Clinic, Wolfson Hospital, Israel.


-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com] On Behalf Of Jai Gupta
Sent: Friday, June 15, 2007 1:07 AM
To: Irene Campbell-Taylor; gerriann jackson; Vera Karger
Cc: dysphagia at b9.com
Subject: Re: [Dysphagia] Practice approaches



Hi,
Does any one audit their work or collect simple information about % of
pt who did not have pneumonia ? Asp i.e. have at least 3 of five
cardinal signs, develop pneumonia or pneumonitis when the pt is under
speech pathologist care. I would like to know if there is data in
general or those using Frazer protocol or those using thickened fluid.
We have been working on performance indicators and setting benchmark and
in our preliminary data collection got some interesting data for various
sites for over 600 pts. If there is some data out there I would like to
compare with our benchmark. Thanks


Jai Gupta. 
 






-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com]On Behalf Of Irene
Campbell-Taylor
Sent: Thursday, 14 June 2007 9:36 PM
To: gerriann jackson; Vera Karger
Cc: dysphagia at b9.com
Subject: Re: [Dysphagia] Practice approaches




gerriann jackson <gjackson at rochester.rr.com> wrote:    

I promote free water between meals, after oral care for my dysphagia
patients.
   
  *** Even the best oral care can never remove all pathogens from the
mouth. I cannot, however, ignore the many videos that I have performed
that demonstrate quite clearly a person aspirating on thin and
tolerating thickened liquids. 
  *** You really must take these findings as what they are- not relevant
to real life. Logemann in her study on thickeners noted that the VFSS
did not match the real life situation - it never does. 
   
  Nor can I ignore the patients who I follow over time
(LTC attached to hospital) who have experienced relief from chronic
upper respiratory symptoms, including repeated pneumonias after being
placed on thickened liquids.
  *** But you don't know all of the variables involved. They are,
undoubtedly, aspirating the thickened liquids as well. See Logemann et
al.  Perhaps, for other reasons, their resistance is better. One cannot
assume that thickened liquids are not aspirated and we now know for
certain that they are.

Research and evidence based practice are important to my practice.
However, there is also evidence and knowledge to be gleaned from every
patient that I treat. 
  *** Absolutely - but one must also know what changes, biochemical,
pharmaceutical, immunological, etc. are taking place before reaching
conclusions based on only one variable.
   
  Those patients and their outcomes tell me that although probably
overused, there is an appropriate place for thickened liquids in the LTC
setting.
  *** I, of course, would have to disagree, and, having never used them
find no reason to suggest that they do have any place - the recent study
supporting this conclusion.

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Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
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