PD and Russian Bolus - Roulette


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Pharyngeal Dysphagia (PD) and Russian Bolus Roulette

When gambling enters medical-therapeutic-nursing-focused dysphagia care management, then the patient is proverbially lost to hops and malt.
First of all, what does the term "Russian Roulette" actually mean? This colloquial phrase illuminates the circumstance of happiness with a high chance of failure - that is, no investment on which one should like to bet. As it happens, this procedure is carried out as follows: a revolver is ammunition with only one cartridge while the remaining five cartridges remain empty. The drum of the revolver is now rotated and at this point in time, the user knows nothing about the whereabouts of the bullet - Bravo.
The consequence is clear, because the game of chance begins and the controlled action competence disappears. With each trigger of the revolver remains unclear, if and when a shot now dissolves. The consequences would be unimaginable and catastrophic.
This is where the metaphorical background ends, and the reference now fully addresses the issue of oral stress and the ability to swallow in patients with pharyngeal dysphagia (PD).

The PD is a phase-specific disorder at the level of the middle pharynx (mesopharynx). Here, the swallowing tract is crossed by two pathways, the oropharyngeal - esophageal (food) and oropharyngeal/nasopharyngeal - laryngeal (airway). At first glance, this consideration seems to be anatomically and physiologically easy to understand, but unfortunately it causes great waves in the practical treatment of dysphagia. Could you please assess whether the ingested oral intake is actually swallowed physiologically - and the bite is not yet a penetration and / or aspiration? Questions about questions and no suitable answer in sight.
This unwanted pragmatic approach often involves an acute deterioration in the general condition with an additional malignant prognosis due to the far-reaching cascade effect with an increase in the morbidity and mortality rates.

And because dysphagiology does not represent a specific subject for the theory of gambling, the following clinical - swallow - therapeutic discourse should give an orientation in the better sensitive understanding and specific handling of PD. Because the greatest risk potential for patients with PD is in the...read more

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Dysphagia and Rehabilitation 26.04.2019

Autor: Christoffer Kern

PD and Russian Bolus - Roulette


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