Moving Forward with Dysphagia Care: Implementing Strategies during the COVID-19 Pandemic and Beyond

Abstract

Growing numbers of SARS-CoV-2 cases coupled with limited understanding of transmissibility and virulence, have challenged the current workflow and clinical care pathways for the dysphagia provider. At the same time, the need for non-COVID-19-related dysphagia care persists. Increased awareness of asymptomatic virus carriers and variable expression of the disease have also focused attention to appropriate patient care in the context of protection for the healthcare workforce. The objective of this review was to create a clinical algorithm and reference for dysphagia clinicians across clinical settings to minimize spread of COVID-19 cases while providing optimal care to patients suffering from swallowing disorders. Every practitioner and healthcare system will likely have different constraints or preferences leading to the utilization of one technique over another. Knowledge about this pandemic increases every day, but the algorithms provided here will help in considering the best options for proceeding with safe and effective dysphagia care in this new era.

Uptake of telepractice among speech-language therapists following COVID-19 pandemic in India

“…Telepractice was thus viewed as a solution to this problem. Telepractice over in-person face-to-face interaction for dysphagia screening and intervention has been recommended to avoid the risk of COVID-19 transmission (Fritz et al, 2020;Miles et al, 2020;Soldatova, Williams, Postma, Falk, & Mirza, 2020).…”

Management of Dysphagia in Nursing Homes During the COVID-19 Pandemic: Strategies and Experiences

“…This commentary has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management. Clinicians should also remain aware of all changes to guidelines on dysphagia management [11,12,14], for nursing homes [33] or for certain clinical populations from other specialities [34].…”

“…Dysphagia management across the two-tiers of residents also differed; the at-risk residents were managed conservatively with diet modification and swallowing manoeuvres [29]. Direct treatments can be considered when these at-risk residents were deescalated to the standard level after the quarantine in the facility [12].…”

“…The risk of the procedure is attributed by the close proximity to the residents' upper mucosa, prolonged exposure and possibility of reflexive cough during the procedures [11]. Compared with the general community, nursing home residents are at substantially higher risk for having bacterial and viral infections [12]. Healthcare workers (HCWs) have to provide care to many residents, which further increases the risk of cross-infection.…”

Disfagia en tiempos de COVID-19

“…Además, durante la evaluación se querrá conocer la fuerza de la tos voluntaria como mecanismo de protección de la vía aérea, por lo que de todos modos se estará expuesto a un mecanismo potente de transmisibilidad y esto es independiente de que un paciente con COVID-19 puede tener tos basalmente por el compromiso de su vía aérea. Por todo ello se considera que tanto la evaluación como el tratamiento de la disfagia producen aerosoles 27,28 y, por ende, se deben tomar las medidas de precaución correspondientes que incluyen el uso adecuado de elementos de protección personal: mascarilla FFP2 o superior, protección facial completa, guantes, gorro y delantal desechable 29,30 .…”