Diagnostic - therapeutic one-way street NPO/nihil per os
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NPO is a diagnostic assignment in the field of dysphagia and underpins the absolute severity of dysphagia. In this case, there is insufficiency for eating, drinking and / or salivary secretions - an acute danger of aspiration with fatal consequences is to be assumed.
In everyday clinical practice, this includes peripherally and centrally induced dysphagia, meaning that this group of patients is no longer offered oral food intake.
But what are the consequences, a hasty decision involves enormous risks, as well as a too late NPO declaration.
In the conclusion, NPO neurophysiologically stands for the total collapse of the swallowing system.
But NPO can not be a long-term diagnosis therapeutically, because every day our swallowing patients do not swallow, the pathological cascade effect further potentiates. Now swallowing therapy skills and knowledge are needed and in the background a good interdisciplinary team.
Because in addition to the early onset of neuromuscular atrophy, neuronal dysfunctions of the perceptual and motor areas occur - virtually destabilizes the network of the swallowing system. The existing functions and possible resources are lost. But the miracle brain continues to learn, it creates the learning of a non-function, so show increasing dysfunction in inter- and intraphasischen swallowing process.
The motto of the Bobaths takes it completely, if you do not use it, you want loose it.
From the practical experience and in the multi-centric exchange can be noted that about 25% of NPO diagnoses in the clinic are deceptively wrong. The reason is often found in the limited treatment of the investigator. In the outpatient area, one can assume a much higher level of concern with misdiagnosis.
The idea of rehabilitation is expedient and we are trying to avoid the impending one-way street NPO. Learn more about a clinical - swallowing approach to improve swallowing in these patients.
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Title and Article Code
Artikel Code: E190809
Dysphagia and Rehabilitation 09.08.2019
Autor: Christoffer Kern
PD and Russian Bolus - Roulette
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