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Digital Seminar

Breathing, Digestion and Swallowing: Best Practices in Dysphagia Management


Speaker:
Angela Mansolillo, MA/CCC-SLP, BCS-S
Duration:
6 Hours 02 Minutes
Format:
Audio and Video
Copyright:
Sep 21, 2021
Product Code:
POS020003
Media Type:
Digital Seminar

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Description

What’s the safest diet? Is he aspirating? Can she swallow these pills? He hates the pureed food – what else can we do? She’s refusing the thick liquids! Is he going to get pneumonia? Does he need a feeding tube?

These are issues that we face every day in our work with children and adults with dysphagia. How do we keep our clients safe, while making sure they’re well hydrated and well nourished, and normalize eating as much as possible?

Sometimes, it’s about more than just swallowing.

This course will examine the inter-relationships between respiration, gastrointestinal function, and swallowing to allow clinicians to better identify the underlying causes of their client’s swallowing difficulties. We’ll look at specific respiratory and GI diagnoses and their impact on what, when, how much, and how safely our clients eat. Using clinical case studies, we’ll examine the evidence to provide you with the tools you need to perform a thorough assessment and implement a comprehensive treatment plan that takes into account all of the potential contributing factors. ​

Credit

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.



* Credit Note - **

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after passing the online post-test (80% passing score) and completing the evaluation). Instructional methods will include PowerPoint, didactic lecture, and others.

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Program content is reviewed periodically per accrediting board rules for currency and appropriateness for credit. Credit approvals are subject to change. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. 
For other credit inquiries not specified below, please contact info@pesi.com or 800-844-8260 before purchase.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

For Planning Committee disclosures, please see the statement above.  For speaker disclosures, please see the faculty biography.


Nurses, Nurse Practitioners, and Clinical Nurse Specialists - ANCC

PESI, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Nurses completing these self-study materials will earn 6.0 contact hours. Expires: 01/06/2025.


California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 6.0 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Florida Nurses

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

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Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.0 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


Occupational Therapists & Occupational Therapy Assistants

 

PESI, Inc.  is an AOTA Approved Provider of professional development. Approved provider # 3322. This Distance Learning-Independent activity is offered at .6  CEUs Intermediate, OT Service Delivery. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

 


Arizona Occupational Therapists & Occupational Therapy Assistants

CE credit is available. This self-study course consists of 6.0​ continuing education clock hours for Arizona OTs and OTAs. The Arizona Board of Occupational Therapy Examiners (R4-43-203) confirms acceptance of continuing education programs relevant to occupational therapy that are approved by the American Occupational Therapy Association (AOTA).


Florida Occupational Therapists & Occupational Therapy Assistants

PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number #50-399. This course qualifies for 6.0 self-study continuing education credits.

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Speech-Language Pathologists & Audiologists

This course contains 6.0 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.


California Speech-Language Pathologists & Audiologists

PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 6.0 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.


Florida Board of Speech-Language Pathology and Audiology

PESI, Inc. is an approved provider with the Florida Board of Speech-Language Pathology and Audiology. Provider Number: 50-399. This self-study course qualifies for 6.0 continuing education credits. 


Kansas Speech-Language Pathologists

Approved for 7.0 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.


Other Professions

This self-study activity qualifies for 6.0 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Handouts/Brochure

Speaker

Angela Mansolillo, MA/CCC-SLP, BCS-S's Profile

Angela Mansolillo, MA/CCC-SLP, BCS-S Related seminars and products


Angela Mansolillo, MA/CCC-SLP, BCS-S, is a speech-language pathologist and Board-Recognized Specialist in Swallowing Disorders with over 21 years of experience. She is a senior speech-language pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts where she is involved in evaluation, treatment, and program planning for adults and children with dysphagia.

Ms. Mansolillo received her Bachelor of Arts degree in communication from Rhode Island College and earned her Master of Arts in speech-language pathology from the University of Connecticut.

 

Speaker Disclosures:
Financial: Angela Mansolillo has an employment relationship with Elms College and Cooley Dickinson Hospital. She is a consultant with Dysphagia Services and receives speaking honorarium from Education Resources, Inc., HomeCEUconnection.com, SpeechPathology.com, Medbridge, Respiratorytherapy.com, ContinuEd. Angela Mansolillo receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Angela Mansolillo is a member of ASHA.


Additional Info

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Questions?

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Objectives

  1. Use your understanding of the interrelationships between the respiratory and gastrointestinal systems to identify and treat the causes and not just the symptoms of dysphagia in your pediatric and adult clients.
  2. Evaluate the impact of respiratory and gastrointestinal functions on swallowing systems in order to choose targeted interventions and increase your effectiveness in reducing aspiration risk.
  3. Design effective treatment plans for clients with respiratory and GI disease processes including COPD, respiratory failure, and GERD.
  4. Prepare your diagnostic tool box to include cough testing, water screenings, pulse oximetry, respiratory muscle strength testing, and other evidence-based tools.
  5. Develop successful treatment plans by identifying reflux disease and its impact on swallowing function in your clients.
  6. Design assessment strategies that allow you to identify those clients who are more likely or less likely to get sick as a result of aspiration.

Outline

RESPIRATORY SYSTEMS

Breathing/swallowing coordination

  • Overview of systems – anatomy/physiology
  • Breathing/Swallow coordination
  • Coordination and aspiration
  • Airway protective mechanisms
  • Reflexive cough

GASTROESOPHAGEAL SYSTEMS

The impact on feeding and swallowing

  • Esophageal function
  • Digestive functions
  • Reflux mechanisms
  • When does GER become GERD?
  • GERD signs and symptoms
  • GERD and feeding/swallowing difficulties
  • Esophageal/Pharyngeal inter-relationships

GI/RESPIRATORY RELATIONSHIPS

What’s the connection?

  • Pressure, energy, and innervation
  • Extra-esophageal reflux

ASPIRATION

How much is too much?

  • Pulmonary Clearance Mechanisms
  • Predictors of pneumonia in various populations

RESPIRATORY DISEASE PROCESSES

The impact on feeding/swallowing

  • Pediatric:
    • Infant Respiratory Distress Syndrome (IRDS)
    • Bronchopulmonary Dysplasia (BPD)
    • Respiratory Synctial Virus (RSV)
    • Congenital Heart defects
  • Adult:
    • Obstructive Sleep Apnea (OSA) and dysphagia
    • Congestive Heart Failure (CHF)
    • Obstructive Conditions
    • Restrictive Conditions

PNEUMONIAS

It’s not all aspiration

  • Pneumonia vs Pneumonitis
  • Community Acquired Pneumonia
  • Healthcare Acquired Pneumonia
  • Aspiration Pneumonia

AIRWAY MANAGEMENT

What’s the impact on swallowing?

  • Non-invasive positive pressure ventilation
  • High flow nasal cannula
  • Intubation
  • Tracheostomies

ASPIRATION ASSESSMENT

Clinical Assessment – Making the Most of your Bedside Eval

  • Cognitive assessment
  • Pitch elevation
  • Serial swallows
  • Oral mechanism
  • Respiratory factors
  • Cough
  • Respiratory muscle strength
  • 3 oz water tests
  • Understanding lab values
  • Pulse Oximetry

Instrumental assessment – Which type and when?

  • Modified Barium Swallow studies
  • Fiberoptic Endoscopic Evaluation of Swallowing

ASPIRATION MANAGEMENT

Diet modifications – Not such a benign intervention

  • Implications of dietary changes
  • Compliance issues
  • Thick liquids – pros and cons
  • Water protocols

Strategies and Exercises – What does the evidence tell us?

  • Compensation
  • Sensory interventions
  • Principles of exercise physiology
  • Lingual strengthening
  • Pharyngeal strengthening
  • Expiratory muscle strength training

REFLUX ASSESSMENT

What do these tests tell me?

  • Upper GI studies
  • Ph Monitoring
  • Esophagoscopy
  • Scintigraphy

REFLUX MANAGEMENT

What’s the dysphagia clinician to do?

  • Lifestyle modifications
  • Positioning
  • Diet modifications
  • Medications
  • Effects of acid suppression
  • Surgical interventions
  • New directions in reflux management

Target Audience

  • Speech-Language Pathologists
  • Speech-Language Pathology Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Respiratory Therapists
  • Nurses
  • Nursing Assistants
  • Restorative Nursing Staff
  • Dietitians
  • Dietary Managers
  • Long-Term Care Professionals

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