Open Trach Question
Hello! I PRN (and am the only SLP) at an ltach and just got notification that a doctor is asking that I do a swallow evaluation on an a patient with an open trach. This patient was tolerating the PMV and on a PO diet a few months ago, but since then has stopped tolerating it and has been NPO for a bit.
Not sure I’ll have luck sending him out for an MBSS, as I tried with a previous patient who was on a vent and is expected to be for life, and the hospital that we requested it from refused d/t risk and liability. The same doctor had pushed for me to evaluate that patient because the patient “said he was eating regular food on the vent at his previous facility.” I’m pretty sure he was just talking that patient for his word because we didn’t have any documented proof of this at our facility at the time (although it later turned out he had done a FEES and the SLP there HAD cleared him for regular textures). He’s also questioned me wanting to get an MBSS before upgrading diets because it “takes too long”.
Not sure what to do/say to the doctor in this situation and it’s making me pretty anxious!