MedSLPedia

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Respiratory muscle training (RMT / RMST) microlearning & support is no longer offered through SLP Mentor in My Pocket and will instead be provided through Brooke's Breathehab program (coming soon!). RMT resources will be retired from SLP MIMP Oct. 2024.

AAC
3 Sections
- Tips on making AAC evals more efficient?
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- Improving AAC strategy carryover with caregivers?
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- How do you get buy-in from your facility to cover AAC devices?
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Acute care
17 Sections
- HHFNC: Is LPM or FiO2 more important?
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- Is person-centered care possible in acute care?
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- Would age, code status, or diagnosis change your decision on whether you'd complete an MBS?
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- Timing swallow evals in acute MS or MG crisis/exacerbation in acute care?
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- What does a cognitive linguistic stroke evaluation look like for you in an acute care setting?
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- Treating communication in advanced dementia in the acute setting?
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- Do we have a role in managing delirium?
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- When would you make the decision to insert a PEG after the patient has been on a NGT?
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- Why do acute stroke patients have fluctuating levels of alertness?
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- Do you recommend a screener for acute care that easily diagnoses aphasia type?
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- Standards for productivity vs billing in acute care?
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- Can patients have speaking valves in the acute post-op phase of esophagectomy?
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- HHFNC: Parameters for holding a swallow eval?
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- How to get involved in GOC discussions in acute?
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- Acute care standard for cognitive-linguistic evals?
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- What are the statistics re: aspiration or silent aspiration post intubation?
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- Where does the blanket recommendation “urgent medications crushed in puree if not contraindicated” come from?
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Aphasia
5 Sections
- Is person-centered care possible in acute care?
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- Suggestions for a non-communicative patient after a large L hemisphere stroke
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- Can the Communication Participation Item Bank be completed by proxy?
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- Can you expand on these aphasia techniques?: ORLA, ACRT, and MOR
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- Do you recommend a screener for acute care that easily diagnoses aphasia type?
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Cognitive communication
12 Sections
- How do major diagnoses affect cognition & swallowing?
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- Most useful or efficient cog-comm assessments in a fast paced acute inpatient setting?
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- How do we treat delirium?
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- Would cognitive eval and treatment be indicated for a patient with PRES?
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- What's the SLP diagnosis code for dementia and cognitive-communication impairment?
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- Advocating for our role in cognition with PM&R doctors
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- What does a cognitive linguistic stroke evaluation look like for you in an acute care setting?
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- Treating communication in advanced dementia in the acute setting?
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- Do we have a role in managing delirium?
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- Dementia: evidence-based interventions when other things aren't working?
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- Acute care standard for cognitive evals?
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- Can prolonged urinary incontinence impact memory and mentation (cog changes related to retention)?
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Dysphagia, swallowing, cough
72 Sections
- Do you use the blue dye test with trach patients?
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- How do major diagnoses affect cognition & swallowing?
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- Can I rely on cough to detect or rule out aspiration?
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- Pulse oximetry to detect aspiration?
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- Tactile-thermal stimulation (TTS) for apraxic dysphagia?
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- How to best evaluate pill swallowing?
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- CSE or MBS for this patient with COPD + esophageal dysphagia?
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- Can MBS prevent Medicare coverage of tube feeds?
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- HHFNC: Parameters for holding a swallow eval?
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- Why did this patient end up NPO with a PEG?
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- Dysphagia in parapharyngeal mass?
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- Copious oral secretions and no dysphagia likely - what to consider?
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- Sudden-onset dysphagia after swallowing a pill - treatment thoughts?
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- If a pt complains of globus sensation, what other things should I be thinking of before jumping to recommend a MBSS or not?
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- Is a VFSS still warranted if an 80-year-old patient did well on a bedside swallow evaluation?
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- Brainstem stroke in acute: swallowing exercises? MBS?
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- Oral motor exercises for facial weakness / dysphagia?
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- Improving cough strength for a person on hospice?
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- What exactly is meant by "frank" aspiration?
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- HHFNC: Is LPM or FiO2 more important?
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- Is it appropriate or ethical for SLPs to recommend NPO status or “recommend” alternative means of nutrition?
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- Do you have any references or recommendations regarding decision making for PEG tube placement vs NG tube following a stroke with moderate to severe dysphagia?
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- CTAR: How much are they supposed to tuck their chin down?
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- Would you have continued this MBS on a patient with MND?
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- How do we advocate for MBS / FEES in the SNF?
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- Would age, code status, or diagnosis change your decision on completing an MBS?
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- Can a patient have a normal esophageal manometry study but still have a motility disorder
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- Any guidance on timing swallow evals in MG and MS crises?
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- Has anyone frozen thin Varibar for VFSS or MBS?
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- When would you recommend a PEG tube?
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- Should I use chest x-ray findings to determine candidacy for an instrumental swallow study?
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- When do you do, or defer, a 3 oz water swallow test / Yale Swallow protocol?
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- Do you have a good resource to point me to for brushing up on different compensatory strategies and when to use them on MBS?
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- What might cause a patient to have a very audible swallow post total thyroidectomy?
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- Why would manometry be normal and not pick up on dysmotility?
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- Recent evidence regarding free water protocol and who it's appropriate for (or not)?
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- Have you ever seen little to no tongue movement with all consistencies on an MBS?
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- Thoughts on the Frazier Free Water Protocol for this patient with severe brain injury?
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- What are you using for an MBS chair for bariatric patients?
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- Are exercises indicated in this patient with likely LMN involvement and advanced cancer?
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- Would swallowing exercises be indicated in a patient with dysphasia following a cerebellopontine angle tumor resection?
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- Do you use the effortful pitch glide exercise and dysphagia therapy when appropriate based on an instrumental?
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- What plan of care would you establish for this patient based on MBS findings and current status?
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- Logistics of possibly removing a thickened liquid restriction for this patient?
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- What would you bill for evaluation and also for treatment of rumination syndrome?
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- Alternatives if a patient is having difficulty swallowing meds?
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- Do you measure and record the amount of barium ingested by the patient during MBS?
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- When would you make the decision to insert a PEG after the patient has been on a NGT?
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- Functional dysphagia treatment resources?
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- Is it typical during a VFSS to not always see a CP bar as prominently with some bolus trials vs others?
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- CTAR contraindications?
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- MDTP for brainstem stroke?
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- Do we have a role in helping patients who have chronic hiccups? How about problematic belching?
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- Patient choked on Levadopa - next step?
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- Advice for when patient swallowing outcomes aren't what you hoped for?
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- How to get involved in GOC discussions in acute?
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- Is an infarct in the pons a concern for silent aspiration?
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- Is a chin tuck an appropriate strategy during MBSS for residue in the valleculae?
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- Is there a phrase you can add to an MBSS report indicating that "impairments” are functional/WFL?
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- Does Medicare require a radiologist to be present or supervise the completion of VFSS?
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- Why would a patient only have difficulty swallowing pills?
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- Could this sialorrhea sensation be from nerve damage?
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- Hospice referral for choking on pills?
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- What does "Patulous esophagus filled with debris" mean?
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- What are the statistics re: aspiration or silent aspiration post intubation?
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- What is descending necrotizing mediastinitis and retropharyngeal fluid collection abscess?
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- Where does the blanket recommendation “urgent medications crushed in puree if not contraindicated” come from?
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- Dysphagia rehab for a patient with MS and a trach?
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- CLIPPERS & episodic dysphagia symptoms
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- What should SLPs know about hiatal hernias?
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- Dysphagia after BOT surgery - why is it worse now?
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- Explaining why we're evaluating swallowing based on chest imaging?
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Essentials & medical
22 Sections
- How do major diagnoses affect cognition & swallowing?
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- How to document the body systems approach in our notes?
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- Resources for predicting deficits based on neuro lesion location?
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- Distinguishing UMN vs LMN lesions
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- Transitioning from Ed to Med - can you help me learn how to write plans of care and determine treatment frequency in these settings?
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- How can I improve my knowledge of medical abbreviations?
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- Is incentive spirometry contraindicated in COPD?
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- Can CN IX have aberrant regeneration after microvascular decompression?
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- What would be the etiology of sialorrhea in CVA patients?
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- How can I tell how advanced a patient’s dementia is?
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- Why do acute stroke patients have fluctuating levels of alertness?
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- ClariFix Cryotherapy: Opinions / experience?
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- What does age indeterminate tiny infarct mean?
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- Does "subacute," as in subacute subdural hematoma mean that the SDH occurred X amount of time ago?
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- Chest imaging: what should we as SLPs know about atelectasis, opacities, etc. seen on imaging?
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- Can you briefly explain sepsis from PNA/UTI?
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- Separating out cranial nerve findings vs facial dyskinesia
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- What should SLPs know about hiatal hernias?
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- Does "convexity" in "trace left temporal convexity subdural hematoma" refer to the shape of the SDH?
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- What happens to SDH / SAH without intervention?
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- When documenting A&Ox4…what questions are you asking?
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- BONUS: Tips for understanding unfamiliar medical terminology
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Motor speech
11 Sections
- My coworker suggested non-speech exercises for dysarthria -- do those work?
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- Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
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- Ataxic dysarthria vs Apraxia of speech
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- How to distinguish and diagnose dysarthria types
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- Reducing muscle tension dysphonia in a person with apraxia
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- What can we do for someone with impaired respiratory support for speech
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- Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
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- If a patient presents with nonverbal oral apraxia, does that mean verbal apraxia is guaranteed?
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- When diagnosing AOS, can you please provide an example of what groping actually looks like?
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- What type of dysarthria would you expect given a diagnosis of a L MCA stroke?
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- Can you go over the subsystems of the dysarthria?
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Professional topics
21 Sections
- Common job interview questions for MedSLPs?
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- What do you wish you knew before stepping foot in a medical facility as an SLP?
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- How do you forgive yourself when you make a mistake?
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- How would you manage a dilemma when half of the speech pathology department disagrees?
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- In NYS is there any issue with working and billing as a CFY without a state license?
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- Which medical code to use for Alzheimer's and dementia?
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- F80.2 is said to be a developmental code, what does that mean?
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- What are tips and recommendations to navigate insurance and billing in medical settings?
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- What are your thoughts on burnout among Med SLPs?
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- Are med SLPs required to work on Saturdays ?
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- What ICD-10 code do you use for a normal swallow evaluation?
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- Toxic work environment with senior clinicians and newer clinicians. What to do about it?
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- How do I know when to discharge an adult outpatient?
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- Is it within our scope to carry out oral care on a patient?
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- How do you handle different points of view between full time and contingent staff members in acute care?
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- Standards for productivity vs billing in acute care?
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- Are you aware of any copyright issues with this measure in terms of reporting the score in a patient's therapy note?
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- Words of wisdom for writing legally defensible documentation?
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- Advice for when patient outcomes aren't what you hoped for?
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- Tips for returning to work after leave of absence?
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- Explaining why we're evaluating swallowing based on chest imaging
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RMT / RMST
15 Sections
- IA150 adapter: Should there be a honking sound?
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- Considerations for EMST with high FIO2 and flow requirements
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- RMT for a patient s/p brainstem tumor resection
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- Continuing EMST in a trach patient who met their swallowing goals?
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- RMT in lateral medullary stroke?
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- RMT for a lung transplant recipient?
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- EMT in acute care: dysphonia and RLN involvement
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- IMT devices
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- Incentive spirometry vs EMT
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- EMT for dysphagia & cough in a person w/ Parkinson Disease
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- EMT in GERD/LPR/reflux
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- EMT for a patient with reduced breath support?
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- IMT or EMT in this complex acute care patient?
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- Setting the EMST75 Lite
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- Is there benefit to EMT in advanced parkinsonism?
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Trach / vent
7 Sections
- Do you use the blue dye test with trach patients?
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- New to trachs -- what to do with this patient?
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- Are there certain ventilator modes which should immediately exclude inline PMV candidacy if all other parameters are within optimal settings?
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- Can patients have speaking valves in the acute post-op phase of esophagectomy?
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- How do you educate nurses about speaking valves?
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- When performing a standard, “best case scenario” in-line PMV assessment, is there urgency to go through all steps quickly?
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- Why would a patient be able to wear the PMV but not capping trials?
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Voice
13 Sections
- Can you give an overview on laryngeal reposturing?
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- Research supporting vocal fold augmentation in patients with Parkinson Disease?
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- Avoiding FEES vs videostroboscopy confusion on a referral
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- New to voice therapy and suspect presbyphonia - thoughts on this treatment plan?
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- Resources for working with patients who have ABductor spasmodic dysphonia?
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- Copyright issues reporting the VHI-10 in a patient's note?
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- VHI-10 as a clinical outcome measure?
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- How might we most appropriately assess ILO (VCD) in the acute inpatient setting?
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- Aphonia in advanced Parkinson Disease: Is it worth working on voicing?
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- How long is too long to wait to ask for a patient to be rescoped?
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- Brainstem strokes: dysarthria vs dysphonia, and ENT referrals?
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- Are unilateral vocal nodules a thing?
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- Treating Bamboo vocal nodules related to rheumatoid arthritis?
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