Key Recommendations for Dysphagia Management
The ESSD commentary highlights several critical considerations for managing dysphagia patients during the pandemic:- Assessment and Treatment Balance: Practitioners must balance the risk of oropharyngeal complications (e.g., aspiration pneumonia, malnutrition) with the risk of COVID-19 infection. Non-urgent assessments may be postponed, and patients should be triaged to determine the necessity of dysphagia assessment.
- Instrumental Assessment: Instrumental assessments (e.g., Videofluoroscopic Swallow Study, Fiberoptic Endoscopic Evaluation of Swallowing) should only be performed if essential and if instrument processing can be guaranteed under COVID-19 conditions.
- Personal Protective Equipment (PPE): Dysphagia management is considered a high-risk, aerosol-generating procedure. Practitioners must use appropriate PPE, including protective eyewear, surgical masks, gloves, and for COVID-positive patients, FFP2/3 masks, disposable gowns, and hairnets.
- Telepractice: Telepractice is highly encouraged to minimize the risk of infection. Compensatory treatments should be prioritized, and in-person procedures should be limited.
Practical Implementation
To effectively implement these recommendations, practitioners should consider the following steps:
- Triaging Patients: Use remote systems (e.g., phone, email, telepractice) to gather information on patient COVID-19 status and dysphagia risk. Confirm details in writing whenever possible.
- Minimizing Aerosol Generation: Avoid procedures that generate aerosols, such as cough reflex testing and gag testing, especially in COVID-positive patients.
- Ensuring Safety During Instrumental Assessments: Perform instrumental assessments only when absolutely necessary and ensure thorough cleaning and processing of instruments.
- Adhering to PPE Protocols: Use the appropriate PPE for both COVID-positive and negative patients. Train staff on proper PPE usage to minimize infection risk.
- Utilizing Telepractice: Implement telepractice for assessments and treatments whenever possible. Encourage patient self-care and compensatory strategies to reduce the need for in-person visits.
Encouraging Further Research
While the ESSD commentary provides a solid foundation, further research is needed to refine dysphagia management practices during the pandemic. Practitioners are encouraged to contribute to this evolving field by documenting their experiences, sharing best practices, and participating in research studies.
To read the original research paper, please follow this link: ESSD Commentary on Dysphagia Management During COVID Pandemia.
