UF COMJ teams up with Claire Mills, PhD, to study PED screening tool

It's common for individuals needing a breathing tube for more than two days to have trouble swallowing after removing the tube. This is called post-extubation dysphagia, or PED. If this swallowing problem isn’t discovered and treated quickly, it may lead to serious health issues. These include choking, lung infections, needing the breathing tube again, surgery to help them breathe, longer stays in the ICU, or even death. Some still have swallowing problems after leaving the hospital.

The cost implications of PED are considerable. Lung infections can add hundreds of thousands of dollars to a patient’s hospital bill. Staying longer in the ICU also means other patients may have to wait for a bed, which can delay elective surgeries.

Currently, there is a lack of appropriate screening tools to identify patients with PED. If patients don’t see a speech-language pathologist, or SLP, soon after removing the breathing tube, swallowing problems may go unnoticed, worsening their condition. Some existing tools that check for swallowing problems were made for patients who have experienced strokes, not for patients coming off breathing tubes.

To help fix this problem, Claire Mills, PhD, from the University of Leeds in the UK, created a new screening tool called the

Leeds Post-Extubation Dysphagia Screen, or L-PEDS. Nurses can use this tool in under 10 minutes. They answer some questions and give the patient small amounts of water to drink in steps: first with a spoon, then with small sips, and finally drinking from a cup. If the patient does well, they can start eating and drinking again. If they don’t, they can’t eat or drink nothing by mouth and will be tested again later or sent to a speech-language pathologist.

Mills is working with the Vose Research Lab at UF Health Jacksonville to study how well the L-PEDS screen works. After the screen, patients will get another exam called a flexible endoscopic evaluation of swallowing, or FEES, to check their swallowing more closely. This research will help doctors and nurses find and treat PED better, keeping patients safer and helping them recover faster.

The University of Florida College of Medicine – Jacksonville is excited to work with Mills on this project during Speech-Language-Hearing Month, as part of its mission to improve health and care in the community.