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AAC Library home
Tips on making AAC evals more efficient?
How to improve carryover of AAC strategies with communication partners?
How do you get buy-in from your facility for AAC devices?
Acute Care Library home
RMT precautions in acute care
Acute care standard for cognitive evals?
How to get involved in GOC discussions in acute?
HHFNC: Parameters for holding a swallow eval?
Can patients have speaking valves in the acute post-op phase of esophagectomy?
Standards for productivity vs billing in acute care?
Do you recommend a screener for acute care that easily diagnoses aphasia type?
Why do acute stroke patients have fluctuating levels of alertness?
In acute care, can you provide an example of when you would make the decision to insert a PEG after the patient has been on a NGT?
Do we have a role in managing delirium?
Treating communication in advanced dementia in the acute setting?
What does a cognitive-linguistic eval look like for you in an acute care setting?
Can you share any helpful guidance on deciding on timing for swallow evaluation in acute care for patients who have a known acute exacerbation of Myasthenia Gravis or Multiple Sclerosis?
Should I use EMST with this patient on HHFNC?
Would age, code status, or diagnosis change your decision on completing an MBS?
Is person-centered care possible in acute care?
HHFNC: Is LPM or FiO2 more important?
Aphasia Library home
Do you recommend a screener for acute care that easily diagnoses aphasia type?
Can you expand on these aphasia techniques?: ORLA, ACRT, and MOR
Can the Communication Participation Item Bank be completed by proxy? Does the Communication Confidence Rating Scale for Aphasia have an MCID?
Suggestions for a non-communicative patient after a large L hemisphere stroke
Is patient-centered care possible in acute care?
Cognitive Communication Library home
Acute care standard for cognitive evals?
Dementia: evidence-based interventions when other things aren't working?
Do we have a role in managing delirium?
Treating communication in advanced dementia in the acute setting?
What does a cognitive-linguistic eval look like for you in an acute care setting?
Recommendations on how to approach physical medicine and rehab doctors about our role in cognition?
What's the SLP Diagnosis Code for Dementia and Cognitive Impairment
Would cognitive eval and treatment be indicated for a patient with PRES?
How do we treat delirium?
Which cognitive-communicative assessments do you find to be the most useful/efficient to administer in a fast-paced acute inpatient setting?
Dysphagia & Swallowing Library home
Could this sialorrhea sensation be from nerve damage?
Why might a patient have difficulty swallowing pills when oropharyngeal and esophageal swallow WFL during MBSS?
Does Medicare require a radiologist to be present or supervise the completion of VFSS?
Is there a phrase you can add to an MBSS report indicating that “impairments” are functional/WFL and intervention is not warranted?
Is a chin tuck an appropriate strategy during MBSS for residue in the valleculae?
Is an infarct in the pons a concern for silent aspiration?
Sudden-onset dysphagia after swallowing a pill - treatment thoughts?
If a pt complains of globus sensation, what other things should I be thinking of before jumping to recommend a MBSS or not?
How to get involved in GOC discussions in acute?
Advice for when patient outcomes aren't what you hoped for?
Copious oral secretions and no dysphagia likely - what to consider?
HHFNC: Parameters for holding a swallow eval?
Patient choked on Levadopa - next step?
Dysphagia in parapharyngeal mass?
Do we have a role in helping patients who have chronic hiccups? How about problematic belching?
Can MBS prevent Medicare coverage of tube feeds?
Why did this patient end up NPO with a PEG?
CSE or MBS for this patient with COPD + esophageal dysphagia?
RMT for dysphagia in lateral medullary stroke?
MDTP for brainstem stroke?
CTAR contraindications?
Is it typical during a VFSS to not always see a CP bar as prominently with some bolus trials vs others?
Functional dysphagia treatment resources?
In acute care, can you provide an example of when you would make the decision to insert a PEG after the patient has been on a NGT?
How to best evaluate pill swallowing?
When conducting a VFSS do you measure and record the amount of Ba ingested by the patient?
Tactile-thermal stimulation (TTS) for apraxic dysphagia?
Can I rely on cough to detect or rule out aspiration?
Pulse oximetry to detect aspiration?
Alternatives if a patient is having difficulty swallowing meds due to dysphagia?
What would you bill for evaluation and also for treatment of rumination syndrome?
Logistics of possibly removing a thickened liquid restriction for this patient?
What plan of care would you establish for this patient based on MBS findings and current status?
Do you use the effortful pitch glide exercise and dysphagia therapy when appropriate based on an instrumental?
Would swallowing exercises be indicated in a patient with dysphasia following a cerebellopontine angle tumor resection?
Are exercises indicated in this patient with likely LMN involvement and advanced cancer?
What are you using for an MBS chair for bariatric patients?
Thoughts on the Frazier Free Water Protocol for this patient with a brain injury?
Have you ever seen little to no tongue movement on an MBS? (A bit of a mystery case!)
Recent evidence regarding free water protocol and who it's appropriate for versus which patients may be safest only with thick liquids?
Why would esophageal manometry be normal and not pick up on dysmotility seen on barium swallow? Patient was advised to avoid triggering foods. Is there anything else we can do to help this patient?
Any thoughts on what might cause a patient to have a very audible swallow post total thyroidectomy?
Do you have a good resource to point to me to for brushing up on different compensatory strategies and when to use them on MBS?
When do you do, or defer, a 3 oz water swallow test / Yale Swallow Protocol?
Should I use chest x-ray findings to determine candidacy for an instrumental swallow study?
When would you recommend a PEG tube?
Freezing thin Varibar for VFSS / MBS? How has it been done in order to be compliant with most hospital policies?
Can you share any helpful guidance on deciding on timing for swallow evaluation in acute care for patients who have a known acute exacerbation of Myasthenia Gravis or Multiple Sclerosis?
Can a patient have a normal esophageal manometry study but still have a motility disorder?
Would age, code status, or diagnosis change your decision on completing an MBS?
How do we advocate for MBS / FEES in the SNF?
Would you have continued this MBS on a patient with MND?
How much are patients supposed to have to tuck their chin down to get to the towel during CTAR?
Do you have any references or recommendations regarding decision making for PEG tube placement versus NG tube following a stroke with moderate to severe dysphagia?
Is it appropriate or ethical for SLPs to recommend NPO status or recommend alternative means of nutrition?
HHFNC: Is LPM or FiO2 more important?
Essentials Library home
Can you briefly explain sepsis from PNA/UTI?
What should we as SLPs know about atelectasis, opacities, etc. seen on chest imaging?
Does "subacute," as in subacute subdural hematoma mean that the SDH occurred X amount of time ago?
What does age indeterminate tiny infarct mean?
ClariFix Cryotherapy: Opinions / experience?
Why do acute stroke patients have fluctuating levels of alertness?
How can I tell how advanced a patient’s dementia is?
What would be the etiology of sialorrhea in CVA patients?
Distinguishing UMN vs LMN lesions
Can CN IX have aberrant regeneration after microvascular decompression?
Transitioning from Ed to Med - can you help me learn how to write plans of care and determine treatment frequency in these settings?
Is incentive spirometry contraindicated in COPD?
How can I improve my knowledge of medical abbreviations?
Resources for predicting deficits based on neuro lesion location?
How do major diagnoses affect cognition & swallowing?
How to document the body systems approach in our notes?
Motor Speech Library home
Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
If a patient presents with nonverbal oral apraxia, does that mean verbal apraxia is guaranteed?
When diagnosing AOS, can you please provide an example of what groping actually looks like?
What type of dysarthria would you expect given a diagnosis of a L MCA stroke?
How to distinguish and diagnose dysarthria types?
Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
Ataxic dysarthria vs Apraxia of Speech?
What can we do for someone with impaired respiratory support for speech?
Reducing muscle tension dysphonia in a person with apraxia and aphasia?
Non-speech exercises for dysarthria?
Professional Topics Library home
Advice for when patient outcomes aren't what you hoped for?
Words of wisdom for writing legally defensible documentation?
Copyright issues reporting a score in a patient's note?
Standards for productivity vs billing in acute care?
How do you handle different point of views between full time and contingent staff members on acute care?
Is it within our scope to carry out oral care on a patient? Or is that the nurse’s role?
How do I know when to discharge an adult outpatient?
Toxic work environment with senior and newer clinicians. What to do about it?
What ICD-10 code do you use when you complete a dysphagia evaluation and find no signs of dysphagia or feeding difficulties?
Are MedSLPs required to work Saturdays?
What are your thoughts on burnout among Med SLPs? I've been wanting to get into the Med SLP realm, but I have Med SLP friends who question me about that.
What are tips and recommendations to navigate insurance and billing in medical settings (ex, SNF, acute, LTAC)? How come some patients are denied for speech therapy ?
When F80.2 is a "developmental code", what does that mean?
Medical Diagnosis for Alzheimer's and Dementia: Which One to Use? 🤔
In NYS is there any issue with working and billing as a CFY without a state license?
How would you manage a dilemma involving transitioning to the MBSImP when half of the speech pathology department is for it and half against it?
How do you forgive yourself when you make a mistake?
What are common job interview questions for MedSLP positions?
What do you wish you knew before stepping foot in a medical facility?
RMT Library home
RMT precautions in acute care
Is EMST contraindicated for patients with a chest tube?
Is EMT contraindicated in vocal polyps?
IMT or EMT in this complex acute care patient?
Setting the EMST75 Lite: guidance
EMT in an acute patient with reduced breath support?
Multiple medical diagnoses and possible contraindication: should we wait on EMT?
RMT in Presbyphonia?
Should I offer EMT to this patient with multiple medical diagnoses?
Benefit of EMT in advanced parkinsonism?
RMT for reduced breath support in acute care?
Sterilizing RMT assessment equipment
Incentive spirometry vs EMT for cough?
EMT for dysphagia & cough in a person w/ Parkinson Disease?
RMT for dysphagia in lateral medullary stroke?
Adjusting an EMT device in the ALS population
How often do you 1) adjust RMT device load and 2) repeat MEP?
How to go about having the hospital cover devices for patients?
RMT in Myotonic Dystrophy for vent liberation?
Can I use a peak flow meter, or just a perception scale, to set an RMT device?
EMT for a lung transplant recipient after a prolonged hospitalization?
Should I use EMST with this patient on HHFNC?
How can my patient get reimbursed for an Aspire device? (EMST150, EMST75 Lite)
Should I continue EMST in this trach patient who has met their swallowing goals?
Is this textbook something you'd recommend SLPs have in their library?
IA150 adapter: should there be a honking sound?
RMT for a patient s/p brainstem tumor resection?
Which RMT devices do you recommend?
Would EMST be indicated in an acute care patient with dysphonia status post total thyroidectomy a week ago?
Trach / Vent Library home
Can patients have speaking valves in the acute post-op phase of esophagectomy?
How do you educate nurses about speaking valves?
Are there certain ventilator modes which should immediately exclude inline PMV candidacy if all other parameters are within optimal settings?
When performing a standard, “best case scenario” in-line PMV assessment, is there urgency to go through all steps quickly?
Do you use the blue dye test with trach patients?
Voice Library home
RMT in Presbyphonia?
New to voice therapy and suspect presbyphonia - thoughts on this treatment plan?
Resources for working with patients who have ABductor spasmodic dysphonia?
Copyright issues reporting the VHI-10 in a patient's note?
VHI-10 as a clinical outcome measure?
Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
How long is too long to wait to ask for a patient to be rescoped?
Are unilateral vocal nodules a thing?
Treating Bamboo vocal nodules related to rheumatoid arthritis?
Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
Is there any research supporting vocal fold augmentation in patients with Parkinson Disease?
How might we most appropriately assess ILO (VCD) in the acute inpatient setting?
Can you give an overview on laryngeal reposturing?
AAC
AAC Library home
Tips on making AAC evals more efficient?
Preview
How to improve carryover of AAC strategies with communication partners?
How do you get buy-in from your facility for AAC devices?
Acute Care
Acute Care Library home
RMT precautions in acute care
Acute care standard for cognitive evals?
How to get involved in GOC discussions in acute?
HHFNC: Parameters for holding a swallow eval?
Can patients have speaking valves in the acute post-op phase of esophagectomy?
Standards for productivity vs billing in acute care?
Do you recommend a screener for acute care that easily diagnoses aphasia type?
Why do acute stroke patients have fluctuating levels of alertness?
In acute care, can you provide an example of when you would make the decision to insert a PEG after the patient has been on a NGT?
Do we have a role in managing delirium?
Treating communication in advanced dementia in the acute setting?
What does a cognitive-linguistic eval look like for you in an acute care setting?
Can you share any helpful guidance on deciding on timing for swallow evaluation in acute care for patients who have a known acute exacerbation of Myasthenia Gravis or Multiple Sclerosis?
Should I use EMST with this patient on HHFNC?
Preview
Would age, code status, or diagnosis change your decision on completing an MBS?
Is person-centered care possible in acute care?
HHFNC: Is LPM or FiO2 more important?
Aphasia
Aphasia Library home
Do you recommend a screener for acute care that easily diagnoses aphasia type?
Can you expand on these aphasia techniques?: ORLA, ACRT, and MOR
Can the Communication Participation Item Bank be completed by proxy? Does the Communication Confidence Rating Scale for Aphasia have an MCID?
Preview
Suggestions for a non-communicative patient after a large L hemisphere stroke
Is patient-centered care possible in acute care?
Cognitive Communication
Cognitive Communication Library home
Acute care standard for cognitive evals?
Dementia: evidence-based interventions when other things aren't working?
Do we have a role in managing delirium?
Treating communication in advanced dementia in the acute setting?
What does a cognitive-linguistic eval look like for you in an acute care setting?
Recommendations on how to approach physical medicine and rehab doctors about our role in cognition?
What's the SLP Diagnosis Code for Dementia and Cognitive Impairment
Would cognitive eval and treatment be indicated for a patient with PRES?
How do we treat delirium?
Preview
Which cognitive-communicative assessments do you find to be the most useful/efficient to administer in a fast-paced acute inpatient setting?
Dysphagia & Swallowing
Dysphagia & Swallowing Library home
Could this sialorrhea sensation be from nerve damage?
Why might a patient have difficulty swallowing pills when oropharyngeal and esophageal swallow WFL during MBSS?
Does Medicare require a radiologist to be present or supervise the completion of VFSS?
Is there a phrase you can add to an MBSS report indicating that “impairments” are functional/WFL and intervention is not warranted?
Is a chin tuck an appropriate strategy during MBSS for residue in the valleculae?
Is an infarct in the pons a concern for silent aspiration?
Sudden-onset dysphagia after swallowing a pill - treatment thoughts?
If a pt complains of globus sensation, what other things should I be thinking of before jumping to recommend a MBSS or not?
How to get involved in GOC discussions in acute?
Advice for when patient outcomes aren't what you hoped for?
Preview
Copious oral secretions and no dysphagia likely - what to consider?
HHFNC: Parameters for holding a swallow eval?
Patient choked on Levadopa - next step?
Dysphagia in parapharyngeal mass?
Do we have a role in helping patients who have chronic hiccups? How about problematic belching?
Can MBS prevent Medicare coverage of tube feeds?
Why did this patient end up NPO with a PEG?
CSE or MBS for this patient with COPD + esophageal dysphagia?
RMT for dysphagia in lateral medullary stroke?
MDTP for brainstem stroke?
CTAR contraindications?
Is it typical during a VFSS to not always see a CP bar as prominently with some bolus trials vs others?
Functional dysphagia treatment resources?
In acute care, can you provide an example of when you would make the decision to insert a PEG after the patient has been on a NGT?
How to best evaluate pill swallowing?
When conducting a VFSS do you measure and record the amount of Ba ingested by the patient?
Tactile-thermal stimulation (TTS) for apraxic dysphagia?
Can I rely on cough to detect or rule out aspiration?
Pulse oximetry to detect aspiration?
Alternatives if a patient is having difficulty swallowing meds due to dysphagia?
What would you bill for evaluation and also for treatment of rumination syndrome?
Logistics of possibly removing a thickened liquid restriction for this patient?
What plan of care would you establish for this patient based on MBS findings and current status?
Do you use the effortful pitch glide exercise and dysphagia therapy when appropriate based on an instrumental?
Would swallowing exercises be indicated in a patient with dysphasia following a cerebellopontine angle tumor resection?
Are exercises indicated in this patient with likely LMN involvement and advanced cancer?
What are you using for an MBS chair for bariatric patients?
Thoughts on the Frazier Free Water Protocol for this patient with a brain injury?
Preview
Have you ever seen little to no tongue movement on an MBS? (A bit of a mystery case!)
Recent evidence regarding free water protocol and who it's appropriate for versus which patients may be safest only with thick liquids?
Why would esophageal manometry be normal and not pick up on dysmotility seen on barium swallow? Patient was advised to avoid triggering foods. Is there anything else we can do to help this patient?
Any thoughts on what might cause a patient to have a very audible swallow post total thyroidectomy?
Do you have a good resource to point to me to for brushing up on different compensatory strategies and when to use them on MBS?
When do you do, or defer, a 3 oz water swallow test / Yale Swallow Protocol?
Should I use chest x-ray findings to determine candidacy for an instrumental swallow study?
When would you recommend a PEG tube?
Freezing thin Varibar for VFSS / MBS? How has it been done in order to be compliant with most hospital policies?
Can you share any helpful guidance on deciding on timing for swallow evaluation in acute care for patients who have a known acute exacerbation of Myasthenia Gravis or Multiple Sclerosis?
Can a patient have a normal esophageal manometry study but still have a motility disorder?
Would age, code status, or diagnosis change your decision on completing an MBS?
How do we advocate for MBS / FEES in the SNF?
Would you have continued this MBS on a patient with MND?
How much are patients supposed to have to tuck their chin down to get to the towel during CTAR?
Do you have any references or recommendations regarding decision making for PEG tube placement versus NG tube following a stroke with moderate to severe dysphagia?
Is it appropriate or ethical for SLPs to recommend NPO status or recommend alternative means of nutrition?
Preview
HHFNC: Is LPM or FiO2 more important?
Essentials & Medical
Essentials Library home
Can you briefly explain sepsis from PNA/UTI?
What should we as SLPs know about atelectasis, opacities, etc. seen on chest imaging?
Does "subacute," as in subacute subdural hematoma mean that the SDH occurred X amount of time ago?
What does age indeterminate tiny infarct mean?
ClariFix Cryotherapy: Opinions / experience?
Why do acute stroke patients have fluctuating levels of alertness?
How can I tell how advanced a patient’s dementia is?
What would be the etiology of sialorrhea in CVA patients?
Distinguishing UMN vs LMN lesions
Can CN IX have aberrant regeneration after microvascular decompression?
Transitioning from Ed to Med - can you help me learn how to write plans of care and determine treatment frequency in these settings?
Is incentive spirometry contraindicated in COPD?
How can I improve my knowledge of medical abbreviations?
Resources for predicting deficits based on neuro lesion location?
How do major diagnoses affect cognition & swallowing?
Preview
How to document the body systems approach in our notes?
Motor Speech
Motor Speech Library home
Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
If a patient presents with nonverbal oral apraxia, does that mean verbal apraxia is guaranteed?
When diagnosing AOS, can you please provide an example of what groping actually looks like?
What type of dysarthria would you expect given a diagnosis of a L MCA stroke?
How to distinguish and diagnose dysarthria types?
Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
Ataxic dysarthria vs Apraxia of Speech?
What can we do for someone with impaired respiratory support for speech?
Reducing muscle tension dysphonia in a person with apraxia and aphasia?
Non-speech exercises for dysarthria?
Preview
Professional Topics
Professional Topics Library home
Advice for when patient outcomes aren't what you hoped for?
Words of wisdom for writing legally defensible documentation?
Copyright issues reporting a score in a patient's note?
Standards for productivity vs billing in acute care?
How do you handle different point of views between full time and contingent staff members on acute care?
Is it within our scope to carry out oral care on a patient? Or is that the nurse’s role?
Preview
How do I know when to discharge an adult outpatient?
Toxic work environment with senior and newer clinicians. What to do about it?
What ICD-10 code do you use when you complete a dysphagia evaluation and find no signs of dysphagia or feeding difficulties?
Are MedSLPs required to work Saturdays?
What are your thoughts on burnout among Med SLPs? I've been wanting to get into the Med SLP realm, but I have Med SLP friends who question me about that.
What are tips and recommendations to navigate insurance and billing in medical settings (ex, SNF, acute, LTAC)? How come some patients are denied for speech therapy ?
When F80.2 is a "developmental code", what does that mean?
Medical Diagnosis for Alzheimer's and Dementia: Which One to Use? 🤔
In NYS is there any issue with working and billing as a CFY without a state license?
How would you manage a dilemma involving transitioning to the MBSImP when half of the speech pathology department is for it and half against it?
How do you forgive yourself when you make a mistake?
Preview
What are common job interview questions for MedSLP positions?
What do you wish you knew before stepping foot in a medical facility?
Respiratory Muscle Training (RMST)
RMT Library home
RMT precautions in acute care
Is EMST contraindicated for patients with a chest tube?
Is EMT contraindicated in vocal polyps?
IMT or EMT in this complex acute care patient?
Setting the EMST75 Lite: guidance
EMT in an acute patient with reduced breath support?
Multiple medical diagnoses and possible contraindication: should we wait on EMT?
RMT in Presbyphonia?
Should I offer EMT to this patient with multiple medical diagnoses?
Benefit of EMT in advanced parkinsonism?
RMT for reduced breath support in acute care?
Sterilizing RMT assessment equipment
Incentive spirometry vs EMT for cough?
EMT for dysphagia & cough in a person w/ Parkinson Disease?
RMT for dysphagia in lateral medullary stroke?
Adjusting an EMT device in the ALS population
How often do you 1) adjust RMT device load and 2) repeat MEP?
Preview
How to go about having the hospital cover devices for patients?
RMT in Myotonic Dystrophy for vent liberation?
Can I use a peak flow meter, or just a perception scale, to set an RMT device?
EMT for a lung transplant recipient after a prolonged hospitalization?
Preview
Should I use EMST with this patient on HHFNC?
Preview
How can my patient get reimbursed for an Aspire device? (EMST150, EMST75 Lite)
Should I continue EMST in this trach patient who has met their swallowing goals?
Is this textbook something you'd recommend SLPs have in their library?
IA150 adapter: should there be a honking sound?
RMT for a patient s/p brainstem tumor resection?
Which RMT devices do you recommend?
Preview
Would EMST be indicated in an acute care patient with dysphonia status post total thyroidectomy a week ago?
Trach & Vent
Trach / Vent Library home
Can patients have speaking valves in the acute post-op phase of esophagectomy?
How do you educate nurses about speaking valves?
Are there certain ventilator modes which should immediately exclude inline PMV candidacy if all other parameters are within optimal settings?
When performing a standard, “best case scenario” in-line PMV assessment, is there urgency to go through all steps quickly?
Do you use the blue dye test with trach patients?
Preview
Voice
Voice Library home
RMT in Presbyphonia?
New to voice therapy and suspect presbyphonia - thoughts on this treatment plan?
Resources for working with patients who have ABductor spasmodic dysphonia?
Copyright issues reporting the VHI-10 in a patient's note?
VHI-10 as a clinical outcome measure?
Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
How long is too long to wait to ask for a patient to be rescoped?
Are unilateral vocal nodules a thing?
Treating Bamboo vocal nodules related to rheumatoid arthritis?
Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
Is there any research supporting vocal fold augmentation in patients with Parkinson Disease?
Preview
How might we most appropriately assess ILO (VCD) in the acute inpatient setting?
Can you give an overview on laryngeal reposturing?
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