Oral trials
Preceding to oral trials should only be administered if the client presents as alert and calm and the oro-phayngeal assessment demonstrated the appropriate structuhospital_food_.jpgre and function necessary for swallowing.
  • Test trials can involve an array of textures and items giving the examiner a better idea of what give the client trouble and are safe


Notes on Fluids:

  • Thin fluids demand good oral and pharyngeal coordination as it is difficult to form a cohesive bolus with them (Good-Fratelli, 2000). Clients with COPD frequently exhibit problems with thin fluids (NHS, 2010). The examiner may therefore choose to start with water as if aspirated, it is fairly safe to the lungs (Groher et. al, 2010). Conversely, the examiner may want to start with thicker fluid and move towards thinner and potentially more ‘difficult’ fluids. Generally, oral trials begin to with fluids as this can tell the practitioner how hydration needs are/can be addressed (Cichero, 2006).

  • As it is important to assess safe swallowing in an everyday context, the examiner should assess using the general amount that the client would swallow. The average mouthful of think fluids swallowed by a male is 25ml, and 20ml by a female (Adnerhill, Ekberg, & Groher, 1989).


Observations during Oral Trials:

  • The clinician should make an effort to trial the client on a variety of consistancies and culturally appropriate food types. It is important to note how the client functions throughout a typical meal
  • Monitor the client’s fatigue levels throughout trails monitor respiration throughout trial




References

Adnerhill, I., Ekberg, O., & Groher, M. (1989). Determining normal bolus size for thin liquids. Dysphagia, 4(1), 1-3.

Cichero, J. (2006). Clinical Assessment, Cervical Ausculation and Pulse Oximetry. In J.A.Y. Cichero & B.E. Murdoch (Eds). Dysphagia: Foundation, Theory and Practice. Chichester: Wiley.

Good-Fratturelli, M. D., Curlee, R. F., & Holle, J. L. Prevalence and nature of dysphagia in va patients with copd referred for videofluoroscopic swallow examination. Journal of Communication Disorders, 33(2), 93-110.

Groher, M. E. C. M. (2010). Dysphagia: Clinical Management in Adults and Children. Maryland Heights: Missouri: Mosby, Inc.

Service, N. H. (2010). Screening for Dysphagia Retrieved Oct.1, 2010, from http://www.elib.scot.nhs.uk/portal/stroke/dysphagia/dysphagia/intro/index.asp