Thank you for registering for this course!

Purpose: The purpose of this self-study course is to provide the participant with opportunities to view FEES exams that were completed on patients in rehabilitation settings and practice interpretation and report writing. There is one introductory video reviewing anatomy as it is viewed through the endoscope and one introductory video demonstrating a normal swallow, then 9 patient videos ranging in oropharyngeal dysphagia severity. The participant will watch each patient video, make their interpretation, write a summary, then compare/contrast their interpretation to the example provided. This is a self-guided course, so your responses are only seen by you. There will be the option to view a “hint” to help the participant become proficient in identifying abnormalities on FEES by giving clues of when/where to look at specific areas. As with anything there will be differing opinions, however, this exercise will familiarize the clinician with FEES interpretation.

Prerequisites: Prior to completing this course, the clinician should be proficient in adult normal swallowing and adult dysphagia and have taken a FEES training course or equivalent FEES training with a mentor. See ASHA’s guidelines for Knowledge and Skills Required for FEES here(http://www.asha.org/policy/KS2002-00069/).

About the Instructor: Selena Reece, MS, CCC-SLP, BCS-S developed this course with the assistance of several FEES-experienced clinicians employed by Carolina Speech Pathology (Kristin Kopp, MS, CCC-SLP, Holly Garrett, MS, CCC-SLP, Ashley Froehlich, MS, CCC-SLP, and Rachel Walt, MS, CCC-SLP). Selena Reece serves as the Director of Educational Resources with CSP where she also carries an active caseload providing mobile FEES services. Selena has performed over 5,000 FEES since 2003 in the acute care, rehabilitation, and long-term care settings.

Learning Objectives:

  • Identify anatomical markers as they are endoscopically.
  • Observe swallowing with multiple boluses to identify any impairments in swallow function.
  • Articulate swallowing deficits in writing.
  • Demonstrate hight inter-rater reliability when comparing results with instructor’s results.

Instructions

  1. Read Instructions
  2. Watch the Introductory Videos
  3. View each patient video, fill in the grid, and complete a written summary
  4. Compare your grid and summary to the example provided
  5. After completing all of the video interpretations, complete the post-test and ASHA Participant form and email to selena.reece@carolinafees.com or fax to 919-342-4613 in order to receive a course completion certificate.

We hope you enjoy this course!

Introductory Videos:

Patient Outlines:

PATIENT 1

Medical history:  82 year old male w/ ARF, DMII, chronic A-Fib, glaucoma, hypothyroidism, mild dementia.

Current diet:  Mechanical Soft/Thin liquids

PATIENT 2

Medical history:  71 year-old male with end stage esophageal CA s/p esophagectomy, CAD, PAD, GERD, anxiety, neuropathy, DMII, hypothyroidism, dyslipidemia, and HTN. Pt is on 2 LPM O2 via nasal cannula.

Current diet:  NPO; PEG

PATIENT 3

Medical History: 84 year-old female w/ dementia, arthritis, GERD, allergic rhinitis, and hypothyroidism

Current Diet: Pureed/Nectar-Thick Liquids

PATIENT 4

Medical History: 57 year-old male w/ COPD, head and neck CA s/p chemo tx/radiation tx/surgery, dysphagia, alcohol and tobacco use, CHF, HTN, protein calorie malnutrition

Current Diet: NPO/PEG; NTL for pleasure

PATIENT 5

Medical History: 95 male w/ CKD, A-fib, vascular dementia, GERD, and pneumonia.

Current Diet:  Regular/Thin Liquids

PATIENT 6

Medical History: 61 year-old female s/p R subtotal parotidectomy w/ facial nerve perservation and R neck dissection, s/p trach, and s/p XRT.

Current Diet:  NPO/PEG

PATIENT 7

Medical History:  63 year-old male w/ respiratory failure, HLD, HTN, CAD, DM, protein calorie malnutrition, severe hepatitis C, acute CVA w/ L hemiplegia, colon CA, and s/p CABG. Pt had a Shiley #6 cuffless trach in place.

Current Diet:  NPO/PEG

PATIENT 8

Medical History:  63 year old female with HTN, HLD, COPD, tobacco use, anxiety, depression, heart disease, severe cervical spine stenosis requiring surgery, and neurogenic bladder. Pt was received 2 LPM O2 via nasal cannula.

Current Diet: NPO/PEG

PATIENT 9

Medical History: 70 year old female with DMII, sepsis, respiratory failure – s/p trach/vent, pneumonia, renal failure, COPD, HTN, heart failure, bowel obstruction, s/p diverting ileostomy, GERD, UTI, and glaucoma. Pt had a cuffless Shiley #6 track in place, receiving 40% O2 via trach collar.

Current Diet: NPO/PEG