E14 Not All Aspiration is Equal: The Evidence Behind The BOLUS Framework with Melissa Kane

<p>Aspiration and aspiration pneumonia are not the same thing. We know this theoretically. In this episode of Dysphagia Research Bites, Chantelle sits down with Melissa Kane to unpack a 2022 tutorial paper that illustrates the case for looking beyond aspiration itself and toward the individual: their host defences, their medical complexity, their oral health, their lifestyle, when determining the real risk of an adverse event.</p><p><br></p><p>This episode covers:</p><ul><li>Why the presence of aspiration does not have a linear relationship with adverse outcomes</li><li>The BOLUS Framework: a clinical tool that consolidates existing evidence into a practical set of risk-assessment questions spanning Bolus variables, Oral care, Lifestyle and ADLs, Unintended (Iatrogenic) risks, and System Health</li></ul><ul><li>How oral health, feeding dependence, mobility, tube presence, and medical co-morbidities each factor into aspiration risk</li></ul><ul><li>The importance of person-centred language when discussing risk with clients and families</li><li>How using this framework in a real-world case enabled a client who was nil by mouth to significantly increase their oral intake and improve quality of life</li></ul><p><br></p><p>The publication this episode is based on:</p><p><br></p><p>Palmer, P. M., &amp; Padilla, A. H. (2022). Risk of an adverse event in individuals who aspirate: A review of current literature on host defenses and individual differences. <em>American Journal of Speech-Language Pathology, 31</em>(1), 148–162. <a href="https://doi.org/10.1044/2021_AJSLP-20-00375" target="_blank" rel="ugc noopener noreferrer">https://doi.org/10.1044/2021_AJSLP-20-00375</a></p><p><br></p><p>Some of the tools &amp; articles mentioned in this episode:</p><ul><li><strong>EAT-10 (Eating Assessment Tool-10):https://www.nhsexpertcorner.com/sites/default/files/2021-04/eat10toolenglish_form.pdf</strong></li></ul><ul><li><strong>Drooling Frequency and Severity Scale (DFSS):</strong> <a href="https://www.movementdisorders.org/MDS-Files1/PDFs/Task-Force-Papers/sm004.doc" target="_blank" rel="ugc noopener noreferrer">https://www.movementdisorders.org/MDS-Files1/PDFs/Task-Force-Papers/sm004.doc</a></li><li><strong>Functional Oral Intake Scale (FOIS):</strong> <a href="https://www.archives-pmr.org/article/S0003-9993(05)00196-6/abstract" target="_blank" rel="ugc noopener noreferrer">https://www.archives-pmr.org/article/S0003-9993(05)00196-6/abstract</a></li><li><strong>Oral Health A