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Edward Chaw DO Kazuko Shem MD Kathleen Castillo MA CCC-SLP BRS-S Sandra Lynn Wong BA RCP James Chang BA CBIS 《Topics in spinal cord injury rehabilitation》2012,18(4):291-299
Background:
Dysphagia is a relatively common secondary complication that occurs after acute cervical spinal cord injury (SCI). The detrimental consequences of dysphagia in SCI include transient hypoxemia, chemical pneumonitis, atelectasis, bronchospasm, and pneumonia. The expedient diagnosis of dysphagia is imperative to reduce the risk of the development of life-threatening complications.Objective:
The objective of this study was to identify risk factors for dysphagia after SCI and associated respiratory considerations in acute cervical SCI.Methods:
Bedside swallow evaluation (BSE) was conducted in 68 individuals with acute cervical SCI who were admitted to an SCI specialty unit. Videofluroscopy swallow study was conducted within 72 hours of BSE when possible.Results:
This prospective study found dysphagia in 30.9% (21 out of 68) of individuals with acute cervical SCI. Tracheostomy (P = .028), ventilator use (P = .012), and nasogastric tube (P = .049) were found to be significant associated factors for dysphagia. Furthermore, individuals with dysphagia had statistically higher occurrences of pneumonia when compared with persons without dysphagia (P < .001). There was also a trend for individuals with dysphagia to have longer length of stay (P = .087).Conclusion:
The role of respiratory care practitioners in the care of individuals with SCI who have dysphagia needs to be recognized. Aggressive respiratory care enables individuals with potential dysphagia to be evaluated by a speech pathologist in a timely manner. Early evaluation and intervention for dysphagia could decrease morbidity and improve overall clinical outcomes. 相似文献2.
Kazuko Shem MD Kathleen Castillo MA CCC-SLP BRS-S Sandra Lynn Wong BA RCP James Chang BA CBIS Stephanie Kolakowsky-Hayner PhD CBIST 《Topics in spinal cord injury rehabilitation》2012,18(1):15-22
Dysphagia occurs in a significant number of individuals with spinal cord injury (SCI) presenting to acute care and inpatient rehabilitation. This prospective study has found dysphagia in nearly 40% of individuals with tetraplegia. Tracheostomy, mechanical ventilation, nasogastric tube, and age are significant risk factors. The detrimental complications of dysphagia in SCI can cause significant morbidity and delays in rehabilitation. Thus, early and accurate diagnosis of dysphagia is imperative to reduce the risk of developing life-threatening complications. Incidence and risk factors of dysphagia and the use of the bedside swallow evaluation (BSE) and videofluoroscopy swallow study (VFSS) to diagnose dysphagia are presented. The often underappreciated role of respiratory therapists, including assist cough, high tidal volume ventilation, and the use of Passy-Muir valve, in the care of individuals with SCI who have dysphagia is discussed. Improved secretion management and respiratory stabilization enable the individuals with dysphagia to be evaluated sooner and safely by a speech pathologist. Early evaluation and intervention could improve upon morbidity and delayed rehabilitation, thus improving overall clinical outcomes. 相似文献
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Strategies to Address Unmet Needs and Facilitate Return to Learn Guideline Adoption Following Concussion 下载免费PDF全文
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Mary Joe White PhD RN Ann Gutierrez MSN RN CRRN CNRN CBIS Celeste McLaughlin MS RN CNS CRRN NEA‐BC Chi Eziakonwa MSN RN CRRN Lois Stephens Newman MSN RN CRRN Margaret White MPH RN ACRN Becky Thayer MSN RN CRRN CBIS Kerry Davis BSN RN CRRN CBIS Margaret Williams MSN RN CRRN Glennys Asselin MSN/ED RN CRRN 《Rehabilitation nursing》2013,38(3):142-152
Interdisciplinary teams in rehabilitation are effective for positive patient outcomes. They require skills in team building and interprofessional collaboration. The Institute of Medicine has interdisciplinary teams as one of the five core competencies for healthcare workers. In reviewing the literature on teams, several themes were developed, such as communication, collaboration, understanding of roles, and educational levels of team members. Using these themes, a survey was developed to assess perceptions of teams by rehabilitation nurses, physical therapists, and occupational therapists. Significant findings came from questions on educational levels of team members between nurses and occupational therapists and also within the nursing groups. Open‐ended questions asked about barriers and facilitators for effective teams. We hope that these pilot results will lead to discussions on how to improve interdisciplinary teams and make them more effective for better patient outcomes. 相似文献
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