Health
Telemedicine needed to diagnose and treat dysphagia in COVID-19 patients, according to doctors
The viruses behind the disease, COVID-19 and SARS-CoV-2, have forced healthcare providers to change the way patients are treated. Clinicians now frequently use telemedicine to see patients for routine examinations, saving on emergency visits. The same applies to rehabilitation. For example, researchers are looking for ways to improve by remotely screening, assessing, and treating patients with COVID-19 and dysphagia (dysphagia).
Healthcare professionals working in contact with areas of the body where SARS-CoV-2 frequently occurs, such as the nose, mouth, and respiratory tract, share a responsibility to involve patients in ways that do not contribute to their spread. Increasingly COVID-19 (Coronavirus Infection) (# If there is no character limit, add parentheses at first appearance. Risks should be weighed before screening, evaluation, or treatment.
Ideally, clinicians assess dysphagia through a clinical (bedside) assessment and one of two standardized tests (video fluoroscopic swallowing study or flexible endoscopic assessment of swallowing). These tests determine swallowing ability, look for changes in the anatomy and movement of the larynx and tongue, analyze airway fragility, and measure other properties related to swallowing physiology.
However, during a pandemic, clinicians diagnosing and treating dysphagia in COVID-19 patients endanger themselves by using these meticulous and physical techniques. And relying on methods such as history reviews and patient reporting of symptoms is not enough.
“Ironically, patients with COVID-19, especially those recently removed from mechanical ventilation in the intensive care unit, most need clinical and instrumental testing to adequately and comprehensively assess dysphagia. May be one of the patients who do, “says Martin B. Brodsky. , Ph.D., Sc.M. , Associate Professor of Physical Therapy and Rehabilitation, Johns Hopkins University School of Medicine.
Therefore, in the September 2020 editorial Physical Therapy and Rehabilitation Archive, Brodsky and his colleague Richard Gilbert, MD, at the Institute of Biological Architecture at the Providence VA Medical Center, said: Accept telemedicine Because of dysphagia.
“To achieve this, clinicians continue to work with third-party payers (including insurance companies) and state and federal programs such as Medicare to support, accept, and use telemedicine. And you need to get financial compensation, like this, “he explains.
Remote treatment of dysphagia is not new and has been studied and practiced for nearly 20 years (to a lesser extent). Previously, however, technical issues, high equipment costs, lack of standardized training, and billing and coverage issues prevented widespread use.
With the advent of COVID-19, everything has changed, says Brodsky.
“Telemedicine for dysphagia has improved significantly in recent years, but patients continue to have limited ability to receive effective telemedicine,” said Brodsky. “In the current pandemic, this is because traditional clinical and instrumental testing used to assess dysphagia puts healthcare professionals treating patients with COVID-19 at risk of getting sick and spreading further. Need to be changed. “
“To enable telemedicine services for dysphagia, we need to quickly transform innovative thinking and technology into clinical practice, more than ever,” adds Brodsky.
Source:
Journal reference:
Brodsky, MB, et al. (2020) Long-term effects of COVID-19 on the assessment and treatment of dysphagia. An archive of physical therapy and rehabilitation. doi.org/10.1016/j.apmr.2020.05.006..
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