Lemon Glycerine Swabs and Xerostomia

"Lemon and glycerine swabs stimulate production of saliva initially but are acidic, causing irritation and decalcification of the teeth and resulting in rebound xerostomia." from Mary Jo Grap et al., “Oral Care Interventions in Critical Care: Frequency and Documentation,” Am J Crit Care 12, no. 2 (March 1, 2003): 113-118. (free full text at http://ajcc.aacnjournals.org/cgi/reprint/12/2/113)

J H Meurman et al., “Hospital mouth-cleaning aids may cause dental erosion,” Special Care in Dentistry: Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry 16, no. 6 (December 1996): 247-250.

Patricia Coleman PhD et al., “Improving oral health care for the frail elderly: A review of widespread problems and best practices,” Geriatric Nursing 23, no. 4 (July 2002): 189-199.

Three Good Dysphagia References

Eisenhuber, E., Schima, W., Schober, E., Pokieser, P., Stadler, A., Scharitzer, M., et al. (2002). Videofluoroscopic assessment of patients with dysphagia: pharyngeal retention is a predictive factor for aspiration. American Journal of Roentgenology, 178(2), 393-398.

Perlman, A. L., Booth, B. M., & Grayhack, J. P. (1994). Videofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia. Dysphagia, 9 (2), 90-95.

Rosenbek, J. C., Robbins, J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration-aspiration scale. Dysphagia, 11(2), 93-98.

Change of Schedule

Will be here on Tuesday, June 30th. Will be off on Thursday, July 2nd instead.

Student Presentations

Date: July 7th at 8am-9am. You will have 10 minutes to present on a topic of interest to seasoned SLPs like me. Location: TBA.

Search this blog for more information on previous years. Type in "Student Presentations." See what comes up.

Good luck!

Anoxic Brain Injury

http://www.brainandspinalcord.org/traumatic-brain-injury-types/anoxic-brain-injury/index.html

VRE, MRSA -- What Else Is New!

Look 'em up! Know why we in healthcare need to be concerned and careful!

Practicum Goals

Reminder: I need your "goals" for the practicum by tomorrow. Thanks!

Tracheal Stenois and Tracheomalacia - Samantha Conner CSD Graduate Student

Two conditions affecting the trachea include tracheomalacia and tracheal stenosis. Tracheal stenosis is a narrowing or constriction of the tracheal cartilage that can cause shortness of breath, coughing, wheezing, stridor, dyspnea, (and pneumonia - are you sure there is a direct cause-effect relationship?) Tracheal stenosis consists of two types, including congenital and acquired. Congenital stenosis occurs at birth. Acquired stenosis can be secondary to tracheostomy, radiation treatment, surgery, and cancer. Also, stenosis can be caused by bacterial infection, external injury, and autoimmune conditions such as polychondritis and sarcoidosis that cause inflammation. However, the majority of cases are due to prolonged intubation.The most common treatments for tracheal stenosis include endoscopic surgery, open surgery and medical treatment. The treatment varies according to the etiology of the stenosis. For example, if the condition is secondary to an infection, it may be treated using antibiotics or antifungals. Also, if it is secondary to a malignant growth, chemotherapy or corticosteroids may be used for treatment. Although surgery is not necessary in most cases, some stenosis requires surgery. Minimally invasive surgery such as endoscopic surgery can be an effective treatment, as well as open surgery such as a tracheal resection. Tracheal stenosis also can be treated by dilation, either performed by a health care provider or at home by savvy patients.

In contrast to tracheal stenosis, tracheomalacia is a condition characterized by weakness of tracheal cartilage. Symptoms of malacia include stridor, dypnea, upper respiratory infections, and pneumonia. Tracheal malacia can be congenital or acquired. Congenital tracheal malacia occurs when the tracheal cartilage is not properly formed. It is often associated with fistulas. Congenital malacia can be treated with humidified air, physical therapy, careful feeding and monitoring, and antibiotics for infections associated with malacia. Acquired stenosis can occur as type II malacia from pressure on the trachea from an outside force such as a tumor. Another acquired malacia, type III, occurs from prolonged intubation or chronic infections. Acquired tracheomalacia can be treated through CPAP (continuos positive airway pressure), or surgery sometimes followed by the placement of a stint.

June, July Practicum Schedule

No practicum on these dates:

Friday, June 12th
Monday, June 15th
Wednesday, June 24th
Tuesday, June 30th

Thursday, July 9th
Wednesday, July 15th
Monday, July 21st
Friday, July 31st

Assignment

Look up tracheomalacia and tracheal stenosis, description and etiology. Treatment options.