Silent aspiration: results of 2,000 video fluoroscopic evaluations

The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study,...

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Published inThe Journal of neuroscience nursing Vol. 41; no. 4; pp. 178 - 185
Main Authors Garon, Bernard R, Sierzant, Tess, Ormiston, Charles
Format Journal Article
LanguageEnglish
Published United States Lippincott Williams & Wilkins, WK Health 01.08.2009
American Association of Neurosurgical Nurses
Subjects
Adolescent
Adult
Aged
Aged, 80 and over
Care and treatment
Cough
Deglutition
Deglutition disorders
Deglutition Disorders - diagnostic imaging
Deglutition Disorders - nursing
Diagnosis
Education, Nursing, Continuing
Female
Fluoroscopy
Health aspects
Humans
Male
Mass Screening
Methods
Middle Aged
Nursing
Pneumonia, Aspiration - diagnostic imaging
Pneumonia, Aspiration - nursing
Retrospective Studies
Young Adult
United States
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Summary:The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.
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ISSN:0888-0395
1945-2810
DOI:10.1097/JNN.0b013e3181aaaade