Question
Should "free" water be discontinued for a patient who has a productive cough or who is having emesis?
Answer
With a productive cough, as long as the patient is not turning red, losing their breath or having medical changes such as heart rate, then they can have the water. I would definitely make sure that I have specific swallowing strategies/precautions in place for the patient. For example, the patient may only be able to have five swallows before coughing or a dry swallow in between each swallow of water. Regarding emesis, if the patient is having a lot of emesis or reflux, I would make sure that was all cleared and the oral care was complete before I allowed free water. Aspiration of stomach contents and stomach acid can medically comprise your patient and may even be deadly.
This Ask the Expert was taken from the course entitled: Water and the Patient with Dysphagia/Frazier Water Protocol
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Gale Estes-Waddell, M.A., CCC-sp has over 25 years of experience working with adults and pediatrics in the acute, rehabilitation, outpatient and home health settings. Gale has developed, consulted and managed several interdisciplinary dysphagia programs. She is trained in Neurodevelopmental treatment for adults. Gale has presented nationally on topics of dysphagia and Neurodevelopmental Therapy.