What is Fiberoptic Endoscopic Evaluation of Swallowing (FEES)?
Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a diagnostic procedure used to assess the anatomy and function of the upper aerodigestive tract during swallowing. It involves the insertion of a flexible endoscope through the nose to directly visualize the pharynx and larynx while the patient swallows different consistencies of food and liquid.
Why is FEES Important in Nursing?
Nurses play a crucial role in the care of patients with dysphagia, or difficulty swallowing. FEES provides real-time visualization of the swallowing process, enabling healthcare providers to identify the cause of dysphagia and develop appropriate treatment plans. This can significantly improve patient safety, nutrition, and overall quality of life.
What are the Indications for FEES?
FEES is indicated for patients who exhibit signs of swallowing difficulties, such as coughing or choking during meals, recurrent pneumonia, unexplained weight loss, or a history of aspiration. It is particularly useful for patients who cannot undergo a modified barium swallow study due to mobility issues or concerns about radiation exposure.
How is FEES Performed?
The procedure is typically performed by a speech-language pathologist or a trained nurse under the supervision of a physician. It involves the following steps:
The patient is seated in an upright position.
A topical anesthetic may be applied to the nasal passages to minimize discomfort.
The endoscope is gently inserted through the nose and advanced to the level of the soft palate.
The patient is asked to swallow various consistencies of food and liquid while the examiner observes the swallowing process on a monitor.
The procedure usually takes about 20-30 minutes.
What are the Risks and Complications of FEES?
FEES is generally considered safe, but like any medical procedure, it carries some risks. Potential complications include nosebleed, gagging, discomfort, and, in rare cases, laryngospasm or bronchospasm. Nurses should monitor patients closely during and after the procedure for any adverse reactions.
Explaining the procedure and addressing any concerns or questions the patient may have.
Ensuring the patient is comfortable and relaxed during the procedure.
Assisting with the preparation of different food and liquid consistencies for the swallowing assessment.
Monitoring the patient for any signs of distress or complications during and after the procedure.
Communicating the results of the FEES to the multidisciplinary team and participating in the development of the patient's care plan.
Direct visualization of the swallowing mechanism, allowing for accurate diagnosis and targeted interventions.
No exposure to radiation, making it safe for repeated use.
Ability to assess swallowing function in a variety of settings, including bedside and outpatient clinics.
Immediate feedback to the patient and healthcare team, facilitating timely adjustments to the care plan.
Conclusion
Fiberoptic Endoscopic Evaluation of Swallowing is a valuable tool in the assessment and management of dysphagia. Nurses play a vital role in supporting patients throughout the FEES procedure and in implementing effective treatment strategies based on the findings. By understanding the indications, procedure, risks, and benefits of FEES, nurses can contribute to improved patient outcomes and quality of life.
