September 2010 Newsletter

Consultants in Dysphagia Evaluation and Management
817-514-MBS1 or 1-888-514-MBS1
September 2010
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
Monthly Motivator:
One of the best uses of your time
is to increase your competence in your key result areas.

Ethics.com: Are you online?– ANOTHER OPPORTUNITY before the end of the year! Texas now requires 2 hours of ethics CEUs, and the deadline for getting these 2 hours will before 2010 if your license is due. Our first course (Ethics.com: Are you online?) in August 2009 and was sold out in 1 week! We had over 140 participants attend in the 2 courses we gave last year. This will be the last time we give this course this year. We hope this is beneficial to many of you that were unable to get their ethics course completed. In addition, this year we will include discussion of the jurisprudence exam (which became a requirement January 1, 2010 for renewal of licensure). The exam can currently be taken online, no more than 6 months prior to the date of licensure application. The exam counts as 1 hour of ethics per renewal year. Registration for the ethics course is included in this newsletter.
E-STIM course – I have had several inquiries about additional E-stim courses at the end of this year. Our next course is October 16, 2010 in Alexandria, LA and Orlando, Florida on October 23rd. For more information on these courses and/or E-stim in general, please call AMPCARE at 817-991-1040.
QA – Quality Assurance – I am sure most of you have received calls regarding this! We have been following up on patients we performed MBSSs for in the month of July. This collection of data will provide us with very important information for research, support the cost effectiveness of a MBSS, and impart critical outcomes. Thank you for your help and time spent with us when we have called to follow up on these particular patients.
Upcoming Holiday – DiagnosTEX will be closed on Labor Day, Monday September 6, 2010. Please consider this when scheduling your studies. Enjoy the holiday!
History of Labor Day – Labor Day is a national legal holiday that is over 100 years old. Over the years, it has evolved from a purely labor union celebration into a general “last fling of summer” festival. It has come to be recognized in the U.S. not only as a celebration of the working class, but even more so as the unofficial end of the summer season. In March 1887, the first state law to declare the day a legal holiday was passed in Colorado, followed by New York, Massachusetts, and New Jersey. In 1894 the U.S. Congress made the day a legal holiday. Labor Day is the celebration of the value and dignity of work and its role in the American way of life.

Telephone or verbal orders for an MBSS on the DiagnosTEX history/consult request form
If a verbal/telephone order is given for the MBSS, a DON or RN can sign the order. If an LVN or charge nurse signs the order, a “standing order” form (delegating this individual to write an order for the physician) must accompany this request. We will keep this information on file at DiagnosTEX for each particular facility to which this pertains. The LVN signature will not be accepted as a written order unless this form is completed and sent to our office. Our new, updated history forms are included in this newsletter. Please use them for your next MBSS request(s). Thank you!!

Monthly Image to the Hall of Frame!
“Don’t ask!!”

Dysphagia Tidbit – Study compares outcome of popular esophageal stents in patients with dysphagia
13. May 2010 04:27
Source: World Journal of Gastroenterology
Less than 50% of patients with esophageal carcinoma are suitable for surgery at the time of diagnosis. Most of these patients present with locally advanced or metastatic disease and/or significant co-morbidities. In such circumstances, the only therapeutic option is palliative care to treat dysphagia and prevent respiratory complications secondary to aspiration. Self-expanding metal stents have been proven effective for palliation of dysphagia in patients with esophageal carcinoma, tracheo-esophageal fistulas or anastomotic leaks. A brief article published on May 14, 2010 in the World Journal of Gastroenterology reports the experience of an Italian high-volume center for esophageal diseases. Dr. Davide Bona, Professor Luigi Bonavina and his colleagues at University of Milan Medical School, IRCCS Policlinico San Donato, investigated the effectiveness, safety and outcome of two most popular esophageal metal stents in patients with dysphagia. The study confirmed that esophageal stents provided good palliation of dysphagia in patients with inoperable esophageal carcinoma. In these patients, metal stents allowed a better quality of life during chemotherapy administration and were safely removed without compromising the subsequent surgical intervention. Good results were also obtained in the conservative management of anastomotic leaks. The results showed that both types of stents used for the study have similar outcomes and that they can both be used as “bridging” therapy before surgical resection.