ICU Clinical Swallow Evaluation—Speech Pathology

The learner is called to the intensive care unit to complete a clinical swallow evaluation of a 55-year-old male who self-extubated following prolonged intubation. The learner will complete a case history, oral motor exam, therapeutic PO trials, make recommendations, and complete a FEES study.

Learning Objectives

1. Learner will demonstrate ability to build rapport, establish trust, and communicate in patient-friendly language.
a. Moderator will provide feedback regarding how well the learner communicates and avoids medical jargon.

2. Learner will identify risk factors for dysphagia specific to this case.
a. Learner will recognize prolonged intubation and hoarse voice as risk factors for dysphagia in this patient based on their dialogue.

3. Learner will identify signs and symptoms of dysphagia/aspiration.
a. Learner will recognize coughing and throat clearing as signs of aspiration.

4. Learner will make appropriate recommendations and referrals.
a. Learner will recommend nothing by mouth as well as an objective swallow study and explain the rationale to the patient.
b. Learner will refer patient to an appropriate medical professional such as an ENT physician.

5. Learner will complete a FEES study at beside.
a. Learner will explain the procedure, identify signs of vocal fold paralysis, recognize aspiration, and attempt a strategy to reduce aspiration risk.