Question
Can tube-fed patients be included in the "free" water/Frazier Water Protocol?
Answer
Yes, absolutely. The tube-fed patient can have water including patients; who are NPO and/or receive partial nutrition via a tube. It is very important to recognize that the patient with an NG tube and even a "stomach tube" have a higher risk of refluxing from the stomach into the esophagus. Positioning in bed (head of bed elevated) and sitting upright will be crucial to reduce risks of reflux. Also assessing the patient's need for specific swallowing strategies/precautions will be important to reduce coughing/choking, reflux, etc. Swallow strategies such as a chin tuck head position, limiting bolus size and/or double swallow may be required to reduce difficulties and/or risks associated with swallowing thin liquids.
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.
