Titre du document

Bronchial auscultation: An effective adjunct to speech and language therapy bedside assessment when detecting dysphagia and aspiration?

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Nom du corpus

Ortho

Auteur(s)
  • Jane L. Shaw B Med Sci 1
  • Sam Sharpe BSc 1
  • Sarah E. Dyson BSc 1
  • Sue Pownall BSc 2
  • Stephen Walters BSc, MSc 3
  • Carol Saul BA, MSc 3
  • Pam Enderby PhD, MSc 3
  • Kerry Healy BSc 1
  • Helen O'Sullivan BSc 1
Affiliation(s)
  • Speech and Language Therapy Department, Doncaster and Bassetlaw NHS Trust, Doncaster Royal Infirmary, Armthorpe Road, DN2 5LT, Doncaster, UK
  • Speech and Language Therapy Department, Sheffield Teaching Hospitals, Royal Hallamshire Hospital (RHH), S10 2JF, Sheffield
  • School of Health and Related Research, Regent Court, S1 4DA, Sheffield, UK
Langue(s) du document
Anglais
Revue

Dysphagia

Éditeur
Springer [journals]
Année de publication
2004
Type de publication
Journal
Type de document
Research-article
Résumé

Detection of aspiration by bedside examination has frequently been found to be clinically inadequate when compared with videofluoroscopy (VF) as the gold standard. In Doncaster, UK, a new multidisciplinary approach to bedside assessment was devised using physiotherapists (PT) performing bronchial auscultation (BA) in combination with the speech and language therapists' (SLT) clinical examination of dysphagia. In this study 105 patients referred for VF examination of dysphagia were first tested by the BA team. Comparison was made between the results of the VF team and the results of the BA team in classifying the patients as “aspirating” or at “risk of aspirating”. A high degree of agreement was found for risk of aspiration (sensitivity 87%), although specificity was low (37%). BA was highly specific (88%) when confirming the absence of aspiration, but sensitivity to the presence of aspiration was 45%. From the 105 patients tested, the BA team would have failed to modify the diet in only one subject who was aspirating and would have unnecessarily modified the diet of 17 subjects. In conclusion, in the sample population of individuals with complex dysphagia, the BA team approach reliably detected patients identified by VF as at risk of aspiration. In the group of patients identified by VF as aspirating, the BA team proved unreliable in detecting the presence of aspiration, although it did reliably identify patients who were not aspirating. BA is a potentially useful clinical tool which requires further research.

Mots-clés d'auteur
  • Aspiration
  • Bronchial auscultation
  • Videofluoroscopy
  • Dysphagia
  • Deglutition
  • Deglutition disorders
Score qualité du texte
9.88
Version PDF
1.3
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Identifiant ISTEX
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Nom du fichier dans la ressource
ortho-ang_0068
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