E06 Risk Feeding, Informed Consent & Prandial Aspiration with Dr Shaun O'Keeffe
Dysphagia Research BitesShow Notes
The guidelines say to manage risk. But what if the guidelines are the problem? In this episode of Dysphagia Research Bites, Dr Shaun O'Keeffe and I unpack his critique of the Royal College of Physicians' guidance on eating and drinking difficulties, and we ask the question that too few clinicians are asking: is our fear of aspiration actually driving good practice, or just driving restriction?
In this episode we cover: The difference between aspiration and aspiration pneumonia, and why conflating them causes harm Why dietary modifications and thickened fluids are not evidence-based strategies for preventing pneumonia The BOLUS Framework and why Shaun takes issue with how it frames risk Why "unsafe swallow" is a term that needs to go The evidence, or lack of it, behind nil by mouth orders for dysphagic patients Informed consent, patient choice, and why quality of life has to be part of the conversation Why the profession is at a crossroads between risk-averse practice and evidence-based care
The article this episode is based on:
O'Keeffe, Shaun & Murray, Aoife & Leslie, Paula & Collins, Lindsey & Lazenby-Paterson, Tracy & Mccurtin, Arlene & Mulkerrin, Siofra & Smith, Alison. (2021). Aspiration, risk and risk feeding: A critique of the royal college of physicians guidance on care of people with eating and drinking difficulties. Advances in Communication and Swallowing. 1-10. 10.3233/ACS-210031.
For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course
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