All Things Airway Mentorship with Candice and Rory!

Candice Devlin, M.S., CCC-SLP, BCS-S and Rory O’Bryan, M.S., CCC-SLP, BCS-S can tell you first-hand how tenacious one must be to build a successful Trach/Vent Team. These two have presented and published on this very topic and can help you!

Sign up for mentorship with and you can discuss all things airway, from selecting appropriate patients for basic and in-line speaking valves to figuring out the right time for dysphagia imaging to respiratory muscle training! These experts are approachable and can create an individualized mentorship program for you based on your specific goals. Whether you feel you have a knowledge gap or need a little guidance with a complex patient, this dynamic duo will utilize their experience and expertise to collaborate and inspire you to serve your patients with high level care. Purchased in one hour increments, you can can set up one-on-one time via phone or Zoom to talk through case studies, work on program development (such as building that trach team), troubleshoot problems, etc.

Check these two out on Swallow Your Pride Podcast Episode: 153

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About the Mentors

Rory O’Bryan, M.S., CCC-SLP, BCS-S
Rory O’Bryan is a Senior Speech Pathologist and Board-Certified Specialist in Swallowing at Duke Regional Hospital in Durham, NC. She also serves as a fee basis employee at the Durham VA Medical Center. Clinical interests include dysphagia in pulmonary critical care, tracheostomy and ventilator dependent patient populations, as well as neurogenic dysphagia. She established and continues to lead her hospital’s multi-disciplinary tracheostomy team and has been instrumental in developing and bringing Respiratory Muscle Training, In-Line Passy-Muir Valve, and IDDSI programs to Duke Regional Hospital. She has published, presented, and been a podcast speaker on oxygen therapies, mechanical ventilation, and swallowing. Ms. O’Bryan earned her Master’s in Communication Sciences and Disorders from the University of North Carolina in 2010. Outside of work, Rory enjoys spending time with her husband and two young kids, exercising outdoors, and traveling with friends.

Candice Devlin, M.S., CCC-SLP, BCS-S
Candice Devlin is a Senior Speech Pathologist and Board-Certified Specialist in Swallowing at Duke Regional Hospital in Durham, NC. She also serves as a fee basis employee at the Durham VA Medical Center. Clinical interests include dysphagia in pulmonary critical care, tracheostomy and ventilator dependent patient populations, as well as neurogenic dysphagia. She established and continues to lead her hospital’s multi-disciplinary tracheostomy team, and has been instrumental in developing and bringing Respiratory Muscle Training, In-Line Passy-Muir Valve, and IDDSI programs to Duke Regional Hospital. She has published, presented, and been a podcast speaker on oxygen therapies, mechanical ventilation, and swallowing. Ms. Devlin earned her Master’s in Communication Sciences and Disorders from East Carolina University in 2009. Outside of work, Candice enjoys spending time with her husband and two young boys, live music, and traveling with friends.

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Frequently Asked Questions

Fiberoptic Endoscopic Evaluation of Swallowing (FEES®) is a well established technique that has revolutionized the field of dysphagia diagnostics. FEES® is a sensitive, accurate, portable, and safe examination that yields clinically useful information relative to swallowing physiology and swallowing safety. The procedure involves passing a flexible endoscope across the floor of a patient’s nasal passage into the pharynx so that the larynx, pharynx and upper esophageal opening are viewed directly from above. Then the patient is administered food or liquids mixed with food coloring in order to determine safe swallowing function and integrity. FEES® can be done at the patient’s bedside, in an office, intensive care unit or in a long-term care facility in under 20 minutes with regular food and liquids. Since there is absolutely no radiation administered, the studies are able to be sustained for longer time intervals, allowing the clinicians the ability to tell if a patient’s swallowing technique is impacted by fatigue.

Susan Langmore, Ph.D., and colleagues coined the term FEES® in 1986 and published the first data demonstrating the effectiveness of the procedure in 1988. It is also known by a few other names such as “video endoscopic evaluation of dysphagia” and “bedside endoscopic swallowing test”. Typically this procedure falls within the scope of practice of speech-language pathology.

The Modified Barium Swallow Study (MBSS), also known as video-fluoroscopic swallow study, is a common, older procedure for the assessment of dysphagia. It is performed in the video-fluoroscopy suite in a hospital involving a radiologist, a radiology technologist and a speech-language pathologist. The patient must be seated in an upright position and fed barium coated food while being x-rayed. The MBSS study is time limited in order to reduce radiation exposure for the patient. The time limitation doesn’t allow for impact of fatigue on a patient’s ability to swallow effectively. Food and liquid consistencies are simulated through the use of liquid barium and barium pastes.

FEES® has repeatedly demonstrated a sensitivity equal to or greater than MBSS in determining whether a patient is exhibiting penetration, aspiration, delay in swallowing initiation and pharyngeal residue. Additionally, FEES® provides visualizations of pharyngeal secretions that cannot be detected during MBSS.

  • No need to coordinate time with radiology department schedule
  • No radiation exposure with FEES®
  • No unpleasant barium-tainted food and no barium-associated constipation for patients
  • No waiting to be cleared from isolation precautions
  • FEES® can be used with patients on mechanical ventilation
  • Normal food is given to patients
  • FEES® can be performed while a patient is sitting upright or in bed
  • FEES® can be performed easily on morbidly obese patients
  • FEES® can be given to medically complex patients who otherwise would not tolerate a trip to radiology
  • Physician does not have to be present during a FEES® study
  • FEES® is displayed and recorded in High Definition digital color
  • The use of the term “gold standard” as applied to MBSS is no longer appropriate
  • Real time visualization and recording allows for documenting functional and structural details
  • There may be cost advantages associated with FEES® for management of dysphagia