Despite a small cohort, our data suggest that the assessment of swallowing to aid weaning in tracheostomised patients is currently performed incorrectly; we estimate that over a third of all tracheostomised patients that 'pass' the clinical assessment of swallowing are, in reality, at risk from penetration, aspiration or failed decannulation. This finding supports the use of fibreoptic endoscopic evaluation of swallowing and a change in clinical practice.
The COVID-19 pandemic was declared by the World Health Organization on 11 March 2020. The rapid spread of SARS-CoV-2 required an equally rapid response from health-care organizations to find innovative ways to utilize the existing workforce to care for people with COVID-19. Using an evaluative case study, a unique insight into the collaborative allied health and nursing professions' response to COVID-19 at a specialist cardiothoracic hospital in the United Kingdom is presented. The aim of the case study was to evaluate how an interprofessional workforce from the wider organization could be supported to work in critical care as part of a crisis response. In identifying the key enablers to setting up an interprofessional Essential Care Team and learning from the lived experiences of those involved, this case study has demonstrated that, in supported, interprofessional teams the wider organizational workforce can be facilitated to effectively and safely provide critical care services. The lessons learned from this study will support future pandemic responses and aid the identification of further opportunities for interprofessional learning and practice. Ultimately, the study highlights that by identifying and investing in the key enablers, health-care organizations can be better prepared to respond to a global crisis.
Lung cancer is one of the most commonly diagnosed cancers across Northern America and Europe. Treatment options offered are dependent on the type of cancer, the location of the tumor, the staging, and the overall health of the person. When surgery for lung cancer is offered, difficulty swallowing is a potential complication that can have several influencing factors. Surgical interaction with the recurrent laryngeal nerve (RLN) can lead to unilateral vocal cord palsy, altering swallow function and safety. Understanding whether the RLN has been preserved, damaged, or sacrificed is integral to understanding the effect on the swallow and the subsequent treatment options available. There is also the risk of post-surgical reduction of physiological reserve, which can reduce the strength and function of the swallow in addition to any surgery specific complications. As lung cancer has a limited prognosis, the clinician must also factor in the palliative phase, as this can further increase the burden of an already compromised swallow. By understanding the surgery and the implications this may have for the swallow, there is the potential to reduce the impact of post-surgical complications and so improve quality of life (QOL) for people with lung cancer.
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