Video Fluoroscopy Shannon Adair, Dietetic Intern January 17, 2013 Shannon Adair, Dietetic Intern...
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Transcript of Video Fluoroscopy Shannon Adair, Dietetic Intern January 17, 2013 Shannon Adair, Dietetic Intern...
Video FluoroscopyVideo FluoroscopyShannon Adair, Dietetic
InternJanuary 17, 2013
Shannon Adair, Dietetic Intern
January 17, 2013
Outline
What is Videofluoroscopy?
•An x-ray “video” of the swallowing mechanism
• 2-3 x-ray images per second
• IP or OP
• Done by SLP and radiologist
•Also called “Modified Barium Swallow”, “Cookie Swallow”, and “Esophagram”
Indications
• Patient’s S/S inconsistent with clinical findings
• Need to confirm/assist in clinical diagnosis
• Patient identified as potential rehab candidate
• Previously diagnosed dysphagia with suspected recurrence
• Chronic degenerative disease
• Reported swallowing difficulty with unknown cause
• Coughing or choking when eating
• Weight loss
• Unusual frequency of chest infection or breathing difficulty
• Size of patient
• Ability to stay in position
• Pregnancy
• Medical instability
• Barium allergy
• May not reflect real meal situations (time, viscosity, awareness)
Contraindications/ Limitations
• In children/infants, make sure they are ready and willing to eat during procedure
• Bring in easy foods and problem foods
Criteria
Treatment
• Patient arrives at radiology department
• Patient sits next to x-ray machine
• SLP provides foods/drinks mixed with barium and asks patient to swallow them
• Progression through food volumes and consistencies
• Puree 1/2 tsp to Puree full tsp
• Nectar 1/2 tsp to Nectar full tsp
• Thin 1/2 tsp to Thin full tsp
•http://www.youtube.com/watch?v=Ri8bBhw9msQ
Normal Example
Aspiration Example
http://www.youtube.com/watch?v=1sFNMk87558
Risks/Side Effects•Radiation
•Minimal levels, low exposure time
•Barium sulfate is an irritant outside GI tract
•Aspiration
•Iodine based contrast
Results
• Determine diet progression
• Discover which foods are safe to swallow
• Discover silent aspirators and confirm suspected aspirators
• Find poorly functional areas of mouth/throat
• Determine whether certain positions or strategies improve swallowing ability
Nutritional Issues
• No special diet prior to procedure
• Diet may change after procedure (consistency, amount consumed)
• Videostroboscopy
• Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Other Tests Available
Questions?Questions?
"Clinical Indicators for Instrumental Assessment of Dysphagia." Clinical Indicators for Instrumental Assessment of Dysphagia. American Speech Language Hearing Association, n.d. Web. 15 Jan. 2013. <http://www.asha.org/docs/html/GL2000-00047.html>.
"Intra Swallow Aspiration." YouTube. YouTube, 09 Aug. 2010. Web. 15 Jan. 2013. <http://www.youtube.com/watch?v=1sFNMk87558>.
"My Swallow Study." YouTube. YouTube, 21 Aug. 2010. Web. 15 Jan. 2013. <http://www.youtube.com/watch?v=Ri8bBhw9msQ>.
"Videofluoroscopic Swallow Study (Modified Barium Swallow)." Duke Cancer Institute, n.d. Web. 15 Jan. 2013. <http://www.dukehealth.org/cancer/health_library/care_guides/treatment_instructions/videofluoroscopicswallowstudy>.
"Videofluoroscopic Swallowing Study (VFSS)." Videofluoroscopic Swallowing Study. American Speech Language Hearing Association, n.d. Web. 15 Jan. 2013. <http://www.asha.org/public/speech/swallowing/Videofluoroscopic-Swallowing-Study/>.
"Videofluoroscopy Swallow Test." Procedures and Treatments. Great Ormond Street Hospital for Children, n.d. Web. 15 Jan. 2013. <http://www.gosh.nhs.uk/medical-conditions/procedures-and-treatments/videofluoroscopy-swallow-test/>.
References