Instrumentation Decision Tool

Dysphagia Instrumentation Decision Tool

Do I need a Swallowing Instrumentation?
This decision tool is intended to help identify those patients that could benefit from a swallowing instrumentation. Knowing what to do can sometimes be confusing, so its important to look at the whole picture. Not everyone needs an instrumentation, but if you do, its vital to get it scheduled and for the SLP to know what's going on.

As you answer the questions, each has a value that will calculate your risk and need to consider receiving a swallowing instrumentation.

You can print this report for yourself and share with your Speech Pathologist, or contact us to find a therapist in your area.

*This tool is for informational purposes only and is not intended to be a substitute for professional medical guidance.
Select All That Apply
Has the patient received a diagnosis of dysphagia?

YES, this is a long-standing diagnosis that was being addressed prior to the most recent episode of illness.YES, this diagnosis is new with the most recent episode of illnessYES, however the patient’s condition has changed and therefore the level of risk has increased.NO
The patient is on an altered diet that was recommended by an SLP:

Mechanical Soft DietPuree DietThickened LiquidsNPO, N-G, or G-Tube FeedNot on an altered diet
Has the patient had a swallowing instrumentation?

YES, MBS (Modified Barium Swallow)YES, FEES (Fiberoptic Endoscopic Evaluation of Swallowing)NO
Was a change in health the reason the patient had a previous swallowing instrumentation?

YESNODid not have one
How long ago did the patient have the swallowing instrumentation?

Within the last 2 WeeksWithin the last MonthWithin the last 3 MonthsOver 3 Months agoDid not have an instrumentation
The patient presently exhibits any one or more of these signs and symptoms of dysphagia: coughing, aspiration, penetration, reflux, choking, congestion, weight loss, dehydration, bronchitis, or pneumonia.

YESNO
The patient has diminished cognitive status for memory, recall, reasoning or judgment.

YESNO
Does the patient have 24/7 help or supervision?

NOYES, a caregiver, or I’m in a Nursing Home with 24 hour careYES, a spouseYES, a family memberYES, but spouse or family member are ill or disabled
The patient has a history of pneumonia, bronchitis, Covid-19, increasing congestion, breathlessness, or chronic cough.

YES, at the present timeYES, within the last monthYES, within the last six monthsNO
Total Score 1-7: No instrumentation necessary at this time. If the patient's condition changes, be sure to contact the healthcare provider or DMS for next steps.
Total Score 8-14: Patient is likely ok for now, but it's very important to monitor for changes in the patient's condition. If anything changes, contact your healthcare provider or DMS for next steps.

Although the Patient Appears Stable on this diet, if you are considering a change, consult your healthcare provider or DMS on the risk and need for instrumentation.
Total Score 15+: Strongly consider a discussion with your Speech-Language Pathologist or Physician to receive a swallowing instrumentation.
Your Total Score
Do you have questions? Would you like help scheduling a Dysphagia Instrumentation?
Please fill out the form below and click SUBMIT. Our Dysphagia Specialists will contact you with the next steps.
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Dysphagia Instrumentation Decision Tool

Select All That Apply

Total Score 1-7: No instrumentation necessary at this time. If the patient's condition changes, be sure to contact the healthcare provider or DMS for next steps.

Total Score 8-14: Patient is likely ok for now, but it's very important to monitor for changes in the patient's condition. If anything changes, contact your healthcare provider or DMS for next steps.

Although the Patient Appears Stable on this diet, if you are considering a change, consult your healthcare provider or DMS on the risk and need for instrumentation.

Total Score 15+: Strongly consider a discussion with your Speech-Language Pathologist or Physician to receive a swallowing instrumentation.

Do you have questions? Would you like help scheduling a Dysphagia Instrumentation?