DMR MEDICAL ADVISORY #98-7
Persons at Risk for Aspiration
- Profound Physical Disabilities, lacking skills in self care, gait, and posture control
- Coughing,, spitting, or choking while eating
- Recurrent vomiting
- Recurrent pneumonias
- Involve Individual/Guardian/Family in process
- Speech and swallowing evaluation with a modified barium swallow
- Upper GI X-ray to assess for gastroesophageal reflux, or identified esophageal damage on endoscopic evaluation
- Swallowing and eating program with monitoring of symptoms
- If unable to maintain nutritional support safely, consider gastrostomy feeding tube.
- If symptoms persist, despite gastrostomy feeding tube, consider either conversion to a jejunostomy feeding tube or fundal plication.