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Write a 8 page essay on Can Bedside Assessment Detect Aspiration.This essay stresses that fiberoptic endoscopic examination of swallowing is highly sensitive for detecting aspiration but cannot provid
Write a 8 page essay on Can Bedside Assessment Detect Aspiration.
This essay stresses that fiberoptic endoscopic examination of swallowing is highly sensitive for detecting aspiration but cannot provide all the details of swallow physiology. FEES also requires sophisticated instrumentation and a skilled examiner. Videofluoroscopic swallowing examination has traditionally been the gold standard, because of its ability in assessing oral, pharyngeal, and cervical esophageal stages of swallowing. However, there are issues of transportation and radiation. VFSE is also not a natural procedure since it examines swallowing in ideal circumstances, in an upright posture and using boluses that are not similar to normal food and liquid intake. The procedure also requires coaching. Both FEES and VFSE are also expensive.
This paper declares that several studies indicate that the dye method is far less sensitive than the glucose reagent method. There are also reports of the potential harm due to the dye. The specificity of the glucose reagent is also less, and the cost is also greater. In view of these limitations, the use of these tests are not justified. The BA team proved unreliable in detecting the presence of aspiration in the group of patients identified by VF as aspirating, it was able to identify patients who were not aspirating. Specificity was found to be 88%, whereas sensitivity was 45%. From this, the study concluded that BA is a potentially useful clinical tool, but requires further research.
