Dyphagia How Best to Treat Term Paper

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Patient can be positioned upright, on the side, or in prone position so that saliva can be swallowed or let drool

2. Cleaning of oral tract and teeth is possible

3. During cuff deflation intervals, only minimal secretions from above the cuff have to be suctioned

4. During cuff-deflation and tube-occlusion intervals, the patient can breathe spontaneously and sufficiently through the upper airway for a minimum of 20 minutes with sufficient and stable oxygen saturation (minimum 95% ± 5%)

5. Patient can swallow his secretions spontaneously or with light stimulation

6. Efficient spontaneous coughing with subsequent swallowing

7. Improved vigilance

8. Exclusion of reflux and frequent vomiting

9. If necessary, fiberoptic endoscopic evaluation of swallowing (FEES)

Nurse (in addition to speech pathologist_s criteria):

1. Decreasing need for tracheal suctioning

2. Secretions are liquid and whitish

3. Patient tolerates a mask for respiratory assistance if necessary

4. Positioning to support respiration and secretion management is possible

5.

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No anesthesia/operations planned for the following week

Physician (in addition to speech pathologist's and nurse's criteria):

1. No acute pulmonary complications, no atelectasis

2. If necessary, evaluation of patency of the upper airway

3. Evaluation of further specific medical contraindications

This study suggests 1) Weaning from the tracheotomy tube and decannulation should take place as fast and safely as possible. It should be the main focus of the medical and therapeutical staff in neurologic rehabilitation, so that the patient can rebuild functional rehabilitation and independence; 2) This is possible with an adequate amount of therapeutic intervention time when a multidisciplinary approach is followed consequently and 3) Further research and exchange is needed to modify the multidisciplinary approach and evaluate it with larger and more homogeneous populations of tracheotomized dysphagic patients......

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