Swallow Screening using Contrast prior to Esophagram: Multidisciplinary team approach to reduce Aspiration related harm

Research Objectives: 1. Discuss Role of an SLP in ruling out aspiration using a multidisciplinary approach prior to esophagram post esophagectomy through the use of contrast swallow with gastrografin.
3. Compare Gastrografin v/s Barium for esophagram

Design: Case study

Setting: Acute care hospital

Participants: Subjects included 18-99 year old individuals recruited from trauma center who were suspected to be at high risk for gastric perforation.

Interventions: Through the use of a multidisciplinary team approach, an SLP can use water-soluble contrast agents (WCAs) to screen a patient within the radiology suite using contrast prior to the gastroenterologist (GI) performing an esophagram.

Main Outcome Measures: Through the use of a multidisciplinary team approach, an SLP can use water-soluble contrast agents (WCAs) to screen a patient within the radiology suite using contrast prior to the gastroenterologist (GI) performing an esophagram. The SLP can then make appropriate recommendations to the GI about number of trials and if a patient is appropriate for an esophagram. Thus, the screening helps reduce the risk of giving a patient increased amounts of WCA if they are likely to aspirate.

Results: The screening helps reduce the risk of giving a patient increased amounts of WCA if they are likely to aspirate. As a result, there is decrease potential harm a patient may experience during an esophagram. Therefore, highlighting the benefits of utilizing a multidisciplinary team.

Conclusions: The SLP can screen the patient to see if they are likely to aspirate on the WCA (e.g., gastrografin) during the esophagram. “Aspiration of Gastrografin is potentially dangerous and could be fatal.” With WCAs patients who aspirate are at risk of “pulmonary edema—occasionally lethal— when aspirated into the lung due to high osmolality and intense inflammatory reaction [and] risk of serious allergic reaction due to reabsorption of iodinated compounds” (FA Manian, 2017) Therefore, by having the SLP use an instrumental assessment to screen the patient prior to esophagram, to determine risk of aspiration of contrast and the SLP can make appropriate recommendations to the GI about number of trials and if a patient is appropriate for an esophagram.

Author(s) Disclosures: N/A