Key Recommendations for Dysphagia Management
According to the review, the following strategies are essential for managing dysphagia during the pandemic:
- Clinical Assessment: Prioritize clinical assessments over instrumental evaluations. Instrumental assessments should be reserved for life-threatening conditions or when clinical evaluations are insufficient.
- Personal Protective Equipment (PPE): Always use appropriate PPE to protect yourself and your patients. This includes N95 masks, gowns, face shields, and gloves.
- Compensatory Methods: Focus on compensatory methods such as texture-modified foods and postural strategies to manage dysphagia safely.
- Telemedicine: Develop and implement telemedicine strategies for diagnosis, follow-up, and rehabilitation to minimize direct contact and reduce infection risk.
Clinical and Instrumental Assessments
During the pandemic, it is recommended to limit the use of aerosol-generating procedures. Clinical assessments should include:
- Detailed medical history
- Eating Assessment Tool-10 (EAT-10)
- Cranial nerve examination
Instrumental assessments such as flexible fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VF) should only be performed when absolutely necessary and under strict protective measures.
Rehabilitation Approaches
For rehabilitation, the focus should be on safe, non-invasive methods:
- Tongue, lips, neck, and temporomandibular joint exercises
- Shaker exercises
- Home-based exercise programs
Face-to-face interventions that pose a high risk of infection should be avoided. Instead, telemedicine can be an effective tool for delivering rehabilitation services.
Telemedicine and Telerehabilitation
Telemedicine has emerged as a crucial tool for managing dysphagia during the pandemic. To implement telemedicine effectively:
- Ensure patients have the cognitive capacity to understand and follow telemedicine protocols.
- Provide clear instructions and support for using telehealth platforms.
- Involve caregivers or family members to assist patients during telemedicine sessions.
By integrating these strategies into your practice, you can enhance your dysphagia management skills and ensure the safety and well-being of your patients during the COVID-19 pandemic.
To read the original research paper, please follow this link: Dysphagia management during COVID-19 pandemic: A review of the literature and international guidelines.
