Best Practice in Swallowing Assessment in COVID-19.
Heather Warner, Nwanmegha Young
PMID 35809094WHAT IT FOUND
No SLP staff tested positive for workplace-acquired COVID after resuming FEES and MBS on 439 COVID-positive hospitalizations.
This suggests instrumental swallowing assessment can be safe with strict PPE and triage algorithms.
Key findings
01No inpatient SLP staff who performed objective swallowing assessments had a positive COVID test linked to workplace exposure during the study period.
02The department resumed instrumental assessments for 439 COVID-positive hospitalizations, performing 312 FEES and 38 MBS evaluations on these patients.
03Safety was maintained using N95 masks, gloves, gowns, and eye protection, alongside algorithms that initially restricted instrumental exams to emergent cases with managerial approval.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is from a single tertiary care center, so findings may not apply to smaller hospitals or different healthcare systems. Only a small percentage of the total sample (439 of 6278) were COVID-positive, limiting the power to detect rare transmission events. Vaccinated staff were not routinely tested unless symptomatic or exposed, meaning asymptomatic infections in staff could have been missed. The study did not compare pre-pandemic assessment data with pandemic-era data to see if diagnostic accuracy or patient outcomes changed. It is an observational report of a service protocol, not a controlled trial, so it cannot prove causality or guarantee safety in all contexts.
Declared interests
None reported in the provided text.
The easy way to misread this
Do not interpret this as proof that FEES/MBS are inherently low-risk aerosol-generating procedures. The safety observed depended entirely on strict PPE and evolving triage algorithms; relaxing these precautions based on this study alone could put staff at risk.