Dysphagia screening conducted prior to order for or receipt of any foods, fluids, or medication by mouth (STR)
CPT4 code
Name of the Procedure:
Dysphagia Screening
- Common name: Swallowing Test
- Technical term: Dysphagia Screening
Summary
Dysphagia screening is a quick and simple assessment used to determine if a person has difficulty swallowing. This screening is performed before the individual takes any foods, fluids, or medications by mouth to ensure safe swallowing and prevent choking or aspiration.
Purpose
The primary aim of the dysphagia screening is to identify swallowing difficulties that might lead to serious complications such as pneumonia, malnutrition, or dehydration. The goal is to ensure the patient can safely consume oral intake without risk.
Indications
Symptoms and conditions warranting the procedure include:
- Recent stroke or neurological injury
- Signs of choking, coughing, or gagging when eating or drinking
- Unexplained weight loss or dehydration
- Frequent respiratory infections
Patient criteria:
- Individuals with known or suspected swallowing problems
- Those who have undergone recent surgeries affecting the throat or esophagus
- Patients with neurological conditions like Parkinson’s disease or multiple sclerosis
Preparation
- No specific preparation is generally required for the patient.
- It is essential that the patient is alert and cooperative.
- Any dentures should be in place as the patient usually wears them.
Procedure Description
- Pre-assessment: Medical history review and initial observation.
- Oral Exam: Examine the patient’s mouth, lips, and tongue for any abnormalities.
- Trial Swallows: Patient is given small amounts of water, food, or medication starting with a teaspoon amount. The healthcare provider observes for coughing, choking, throat clearing, or changes in voice quality.
- Monitoring: Continuous observation of the patient’s ability to handle and swallow the food safely.
Tools and Equipment:
- Disposable cups and spoons
- Various consistencies of food and fluids (water, apple sauce, crackers)
- Stethoscope for auscultation of breath sounds, if necessary
Duration
The screening typically takes about 10-15 minutes.
Setting
This procedure can be performed in a variety of settings including hospitals, outpatient clinics, nursing homes, and even at the patient’s bedside.
Personnel
- Speech-language pathologists
- Nurses
- Occasionally, physicians or nurse practitioners
Risks and Complications
- The procedure is generally safe and non-invasive.
- Rarely, minor risks include a temporary sensation of choking or discomfort.
- Immediate management includes stopping the test and taking measures to ensure the patient's airway remains clear.
Benefits
- Early detection of swallowing disorders.
- Prevention of aspiration pneumonia and other complications.
- Enables timely intervention and proper dietary adjustments.
Recovery
- There is no recovery time required as it is a non-invasive screening.
- Follow-up might include a more comprehensive swallowing evaluation or modified diets based on findings.
Alternatives
- Comprehensive Swallowing Evaluation by a Speech-Language Pathologist
- Videofluoroscopic Swallowing Study (VFSS)
- Fiberoptic Endoscopic Examination of Swallowing (FEES)
Alternatives Comparison:
- Comprehensive Swallowing Evaluation: More detailed but longer and requires specialized training.
- VFSS: Offers visual imaging of the swallow but involves exposure to radiation.
- FEES: Provides detailed view but is more invasive and may be uncomfortable for some patients.
Patient Experience
- During the procedure, patients typically do not experience pain but may feel some anxiety related to swallowing testing.
- Post-procedure, there are no lasting effects, and patients can return to their normal activities immediately.
- If abnormalities are detected, patients may be guided on appropriate dietary modifications for comfort and safety.