Bedside Swallow Evaluation
The Bedside Swallow Evaluation (BSE) is a clinical assessment used to evaluate a patient's swallowing function at the bedside. This evaluation is crucial for identifying dysphagia, assessing aspiration risk, and guiding appropriate interventions to ensure safe oral intake. The BSE involves a systematic assessment of various components of swallowing, including oral motor function, sensory awareness, and coordination of swallowing reflexes.
Patient Information
Name | |
Age | |
Gender | |
Medical Record Number | |
Date of Evaluation | |
Clinical Presentation:
Chief Complaint | |
Relevant Medical History | |
Observation
1. Oral Mechanism Examination | Yes | No |
|---|
Lip Closure | | |
Tongue Mobility | | |
Palatal Elevation | | |
Laryngeal Elevation | | |
Presence of Oral Residue | | |
2. Cough Reflex | Yes | No |
|---|
Spontaneous Cough | | |
ough After Swallowing | | |
Ability to Clear Secretions | | |
3. Voice Quality | Yes | No |
|---|
Wet/Gurgly Voice | | |
Hoarseness | | |
Vocal Effort | | |
4. Oral Sensation | Yes | No |
|---|
Sensory Awareness | | |
Gag Reflex | | |
Ability to Detect Food in Mouth | | |
Swallowing Trials
1. Liquid Consistency | Yes | No |
|---|
Volume | | |
Ability to Initiate Swallow | | |
Presence of Coughing | | |
Signs of Aspiration | | |
2. Pureed Consistency | Yes | No |
|---|
Texture Tolerance | | |
Mastication Ability | | |
Bolus Formation | | |
Swallowing Coordination | | |
3. Solid Consistency | Yes | No |
|---|
Texture Tolerance | | |
Mastication Ability | | |
Bolus Formation | | |
Swallowing Coordination | | |
Overall Assessment
Overall Swallowing Safety | |
Recommendations/Interventions | |
Comment/Feedback |
|---|
Provide any additional comments or feedback regarding the evaluation process or the patient's swallowing function. |
[Evaluator's Signature Over Printed Name]
Evaluation Templates @ Template.net
