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Dysphagia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Difficulty swallowing

  • Can be neuromuscular or mechanical

Etiology

  • Oropharyngeal (transfer) dysphagia:

    • Difficulty transferring from the mouth to the proximal esophagus (difficulty initiat...

Diagnosis

Signs and Symptoms

  • Difficulty initiating swallowing

  • Sensation of food stuck after swallowing

  • Cough/choke after eating

  • Impairment of gag reflex and ability to clear bolus

  • Voice change/dysphonia

  • Dro...

Treatment

Pre-Hospital

  • Vigilant airway attention

  • Position of comfort with suction available

Initial Stabilization/Therapy

  • Vigilant airway attention

  • Position of comfort with suction available

  • NPO

  • 0.9% NS 500 ...

Follow-Up

Disposition

Admission Criteria

  • Esophageal obstruction persists despite treatment

  • Compromised fluid or nutrition status

  • Inability to protect airway

  • Unable to tolerate own secretions

Discharge Criteria

Pearls and Pitfalls

  • Consider foreign-body aspiration in children presenting with dysphagia.

  • Dysphagia is a common presentation in stroke.

  • Consider in patients with recurrent pneumonia.

  • Assess for life-th...

Additional Reading

  • Fass  R. Evaluation of dysphagia in adults. Cited from UpToDate.com. Accessed February 22, 2013.

  • Furnival  RA, Woodward  GA. Pain-dysphagia. In: Fleisher  GR, Ludwig  S, Henretig  FM...

Codes

ICD9

  • 787.20 Dysphagia, unspecified

  • 787.22 Dysphagia, oropharyngeal phase

  • 787.24 Dysphagia, pharyngoesophageal phase

  • 787.29 Other dysphagia

  • 787.21 Dysphagia, oral phase

  • 787.23 Dysphagia, pharyngeal pha...

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