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Dysphagia Management During COVID-19: Where Are We Today? - Shared screen with speaker view
Renata Guedes
33:07
Good evening everyone! Thanks for the opportunity to listen and learn from you! :)
Jennifer Trimble
34:55
I'm having a hard time hearing you and my volume is up to max
Susan Browning
35:33
the sound is good on my end
Yvonne Chia
35:35
Volume is working alright on my end
Jennifer Trimble
35:53
I figured it out.
Susan Browning
36:17
👍
Ana Furkim
36:26
i am not hearing!!
Mannar Haddad
45:32
will the recorded version be accessible for a later watch?
CAROLYN PERRY
45:40
if N95's are not available, are KN95's considered an adequate substitute?
Carol Gaebler
45:51
Once the negative COVID test results are confirmed for inpts, does ASHA still recommend N-95 masks for all AGPs.
Monica Sampson
47:01
Yes - the recording will be available later.
Christie Miller
47:06
Are any of the speakers doing FEES with COVID positive patients?
Shaylin Schundler
48:52
In my outpatient clinic, our company has just issued guidelines in the past 2 weeks that, in addition to the N95 and other PPE, we also are required to close off the room for 2 hours after any dysphagia treatment/evaluation (COVID positive or not due to unknown status). This is theoretically to allow the aerosolized particles to settle. This has been extremely difficult with regards to scheduling in a small outpatient clinic with only 2 rooms available. Would you think this 2 hour window is necessary?
Susan Browning
52:32
I have heard one hour in some settings too.
Gerardo Gutierrez
53:01
We have been told it is dependent on the rate at which the HVAC system circulates the air
Karen Copeland
54:23
Would the panelists consider a LSVT or Speak Out! session to be an AGP?
Suri Krause
57:12
What about doing EMST with a COVID negative pt?
Xhorxhina Canaj
01:01:09
what about children with tube feeding? how we can help them?
Shaylin Schundler
01:04:19
We've actually been using EMST with COVID recovered patients due to their new SOB impacting speech. It's been a population we've found really benefits from it
Margo Naraghi-Grcich
01:05:31
What about IOPI?
Denise Bambinelli
01:06:55
Was curious if anyone had opinions on diet recommendations (in the acute setting) for specifically patients who have had poor O2 Sats, and a high level O2 requirement. They may be at risk for aspiration due to the level of O2, not necessarily an oral or pharyngeal Dysphagia at baseline. It felt very subjective at times?
Catherine Osterritter
01:07:10
To what extent have covid symptoms impacted diet recommendations?
Ashley Lopez
01:07:57
when needed we complete an MBS but our infection control restricts us from FEES with Covid +
Ashley Lopez
01:08:37
despite the appropriate PPE available
CAROLYN PERRY
01:08:43
please comment on tests used that are validated for use via tmannerelepractice or how you have made recommendations in a non-standardized
Isabel Nunez
01:09:05
Can somebody comment on the safety aspects of doing a bedside clinical swallow eval via telehealth? Has anybody instructed patients to take foods/liquids trials during a telehealth session?
CAROLYN PERRY
01:09:08
use via telepractice
Anita Senthinathan
01:15:27
I would love to hear the panelists (or attendees) thoughts/ideas/barriers faced related to training SLP students in dysphagia assesment and management during the pandemic.
Karen Sheffler
01:15:49
https://www.purdue.edu/i-eatlab/telehealth-recommendations-for-dysphagia-management-during-covid-19/
Yvonne Chia
01:17:00
Thanks for the purdue link
Gail Meyrowitz
01:21:02
how long of a time is a rest?
Ashley Lopez
01:21:36
what about continuous PPE for all covid patients? is that recommended or frowned upon?
Kim Gonzales
01:24:50
I work at a CIRH/LTACH (HIH) so the host hospital provides our MBSS. The issue I am running into now is they are still requiring 2 negative covid swabs before they will test. As you all know patients will test negative and then positive or indeterminate before we can get 2 negatives and I find it is delaying their progress. I have made the clinical decision to advance some of their diets without the modified...
Kim Gonzales
01:25:01
Can you comment Luis???
Kevin Dent
01:25:55
what about FEES in a SNF setting?
Susan Browning
01:27:18
yes, I would definitely agree with that!!
Cheryl Lopez
01:27:30
when we had push back from radiology for covid +mbs we linked hospitalist to radiologist for peer to peer discussion
Susan Browning
01:28:01
I believe you can definitely do more during the clinical bedside evaluation that we realize.
Optim LLC
01:28:35
Kevin Kent I would love to hear about opinions of the panel of mobile FEES in a SNF setting ............
Kevin Dent
01:29:28
cervical auscultation, done correctly, is very valuable right now
Shaylin Schundler
01:29:57
Where can we find this reference list? Will it be sent out?
Brenda Baldeon
01:30:56
I agree Susan Browning.
Xhorxhina Canaj
01:31:50
where can we find some resourses about manners how we can work with patients with disphagia ?
Monica Sampson
01:31:54
References available in the SLP Health Care Library. You will need to login to your account.https://community.asha.org/viewdocument/dysphagia-management-during-covid-1?CommunityKey=f1b028b3-5098-4091-b854-2bdee3dec2b7&tab=librarydocuments&LibraryFolderKey=&DefaultView=folder
Kim
01:31:55
speaking of oral care- I’ve seen patients that were proned for days with terrible labial, facial and lingual wounds. how are you managing that in terms of oral care and and swallowing?
rhall
01:32:30
]\
Kevin Dent
01:32:39
We all know oral care doesn't really exist in a SNF setting
Christie Miller
01:32:45
That question came up today - how is oral care getting done in the prone position? We have seen patients with pressure sores on their face from being prone.
Isabel Nunez
01:34:08
I agree with Susan Browning too! In some circumstances, observation and the clinical bedside gives us more information than the MBSS, which only gives us a snapshot in time (especially with very frail /elderly clients). Many of us are under-confident in our clinical evaluation ability
Karen Sheffler
01:36:15
Published 7/27/2020, was the validation of the Yale Swallow Protocol for post-acute care. This can help u make decisions for instrumentals or not with a well done Yale Swallow Protocol. We heard from author, Matt Ward, on Ed Bice’s Journal club on facebook last night. article Validation of the Yale Swallow Protocol in Post Acute Care: A Prospective Doubleblind, Multirater Study. This is great news for SLPs who work outside of the acute setting! The article can be found at this link: https://pubs.asha.org/doi/10.1044/2020_AJSLP-19-00147?fbclid=IwAR26NTcyjFL7EnrnhltVm2ewLStdC_6GbXvotiB_XEV83Ixt70fMwDaz8R4
Susan Browning
01:36:29
I have worked in post acute/snf since 2001. My experience has been a long standing history of limited instrumental studies available. this conversation is fabulous!
Susan Browning
01:37:21
I agree with you too Isabel!
Susan Wranik
01:42:24
Kudos Dr. Riquelme for your emphasis on quality of life and focusing on humanity/treating the person! God bless common sense - not so common. Thank you for recommending holding off on intubation and using then smaller cannulas. Now, if we can only convince the medical staff.
misterSLP
01:42:36
Our facility does not allow MBS for COVID+ patients.
Kevin Dent
01:42:47
well said Susan
Susan Browning
01:43:17
I agree with Susan W too!!!
Susan Wranik
01:45:02
Thank you! One for all and all for one. Speech must advocate for those who cannot do so for themselves. Frankly, it's scary how little other disciplines know about swallow function.
Optim LLC
01:45:45
Mobile FEES thoughts in LTC ?
Meg ipad
01:46:19
In home care in AZ, I’m seeing patients whose families received minimal info about the acute care dysphagia assmt tx, making collaboration more important than ever. I’ve had great response from acute SLPs, thanks!
Kevin Dent
01:46:31
our endoscopists aren't allowed in the building to perform the fees currently
Mary Casper
01:47:32
We allow them in for most states with screening.
Optim LLC
01:47:43
It's happening ............
Meg ipad
01:47:55
AZ has mobile FEES
jchrysafi
01:47:56
We are trying to re-start out FEES program in acute care with restrictions
Sahi Remote
01:47:58
Any input on COVID proning and laryngeal trauma?
Susan Stringer
01:48:13
anyone doing VitalStim and seeing the increased need for that?
Ashley Lopez
01:48:14
I have seen pressure sores
Susan Browning
01:48:15
I have heard Dysphagia Management Systems is doing it in some areas when allowed
Mary Casper
01:48:16
We are assessing the clinical need and allowing it on a case by case basis.
misterSLP
01:48:35
Yes, very common. Nursing will typically take care of the pressure sores. Eventually with time it heals.
Ashley Lopez
01:48:59
wound care sees them at my facility
Ashley Lopez
01:49:40
what about abnormal oral mech exams after proning?
Ashley Lopez
01:50:09
without neurological changes
tacit
01:52:06
Good perspectives, Luis! Thank you!
Susan Wranik
01:52:29
Great paper! Never before in the history of medicine has the need for collaborative care been more pronounced.
Susan Wranik
01:53:51
Thank you to the moderator and panelists for giving so generously of your time and knowledge.
Margarita Lopez-Longoria
01:54:55
Thank y’all!
Barbara Welter
01:55:47
we are doing out patient FEES after Covid test with negative results
Barbara Welter
01:56:23
thanks everyone!
Karen Sheffler
01:57:18
Yeah Rinki! thanks
Karen Copeland
01:57:21
Thank you all so very much! As weird as this all is, we are going to be a stronger profession for navigating through this together. :)
Susan Browning
01:57:35
agreed!
Barbara Brindle
01:57:36
Where can I get a copy of the Reference list?
Karen Sheffler
01:57:36
thank you all!!
Optim LLC
01:57:40
Great presentation Thank you !!!
gwen yim
01:57:58
Thank you! Thank You!
Monica Sampson
01:57:59
References available in the SLP Health Care Community Library. You will need to login to your account.https://community.asha.org/viewdocument/dysphagia-management-during-covid-1?CommunityKey=f1b028b3-5098-4091-b854-2bdee3dec2b7&tab=librarydocuments&LibraryFolderKey=&DefaultView=folder
Susan Browning
01:58:03
yes, an excellent discussion!
Rachel Neugroschel
01:58:03
Thank you panelists for your time!!
Isabel Nunez
01:58:11
Thank you all so much. This discussion has been so useful :)
Gail Meyrowitz
01:58:37
+Just a big thank you. Quick question…What face shield do you like? Ive been disappointed in all trials so far
Christine Pencheff
01:58:46
Thank you, everyone. This was very helpful!
elisa
01:58:46
Thank you to the panelists and moderator for giving us their time to discuss such an important topic!
Karen Sheffler
01:58:48
ASHA - thanks for link! here it is again: References available in the SLP Health Care Library. You will need to login to your account.https://community.asha.org/viewdocument/dysphagia-management-during-covid-1?CommunityKey=f1b028b3-5098-4091-b854-2bdee3dec2b7&tab=librarydocuments&LibraryFolderKey=&DefaultView=folder
Leslie Martin
01:59:13
Thank you so much for your time and knowledge.
Robin Andrade
01:59:21
Thank you so much for your time and information!
Anita Senthinathan
01:59:32
Thank you everyone!
Susan Wranik
01:59:37
Final comment: no matter what the dx/how grave the diagnosis/how critical the situation, important to remember that we are treating PEOPLE.
mariella Poblete
01:59:41
Thank you so much!
Barbara Brindle
02:00:00
Thank you.
Susan Browning
02:00:36
yes, we are treating family and friends! so important to remember this.
Anita Senthinathan
02:00:50
Yessss!!
Paige Wintermute
02:00:52
Thank you!!!
sally asquith
02:00:57
Luis, yes! Opportunities to promote, support. Well said.
Chana Hartman
02:01:11
thank you stay safe and healthy
Ashley Lopez
02:01:14
🙌
Xhorxhina Canaj
02:01:27
thank you
Scott Schilling
02:01:33
Thank you! This was very informative!
tacit
02:01:50
Many thanks to all speakers….we need to continue these….
misterSLP
02:02:15
Thank you to all the panelists for hosting this!
jennifer
02:02:28
Thank you!
Nicole Cortes
02:02:39
Thank you so much everyone, it was wonderful hearing from you all!!!
Rachel Neugroschel
02:02:42
thanks again everyone!
Maggie D
02:02:45
Thank you!
Priya Foster
02:02:48
This was very informative! Thank you!
Ashley Lopez
02:02:57
thank you!!
Kathryn Hayes
02:02:58
Wonderful! Thank you!
Stephanie Mataya
02:03:06
Thank you!
Rebecca Brown
02:03:57
Thank you!!
Brenda Baldeon
02:04:24
Appreciate the time and information!
Meg ipad
02:04:24
wonderful presenters, thank you!
ssigmund
02:04:37
Thank you!
Fidelia Schnarr
02:04:42
thank you