Paeds Cases · respiratory-sleep-and-airway
Explain chronic aspiration and a feeding plan to a parent — OSCE
OSCE communication and shared-planning station: explaining to a parent why their child with cerebral palsy keeps getting chest infections, what silent aspiration means, why a swallow study is needed, and how a feeding, saliva and lung-protection plan will work.
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You are the paediatric registrar. A 3-year-old boy with cerebral palsy is recovering from his third pneumonia this year, each in the right lower lung. His mother has ten minutes with you. She wants to understand, in plain language: (1) why this keeps happening when he does not cough on his feeds; (2) what a swallow study will involve; and (3) whether he will need a feeding tube. Explain with empathy, check understanding, and agree a clear plan. [1]
References4ShowHide
- [1]Boesch RP, Daines C, Willging JP, et al. Advances in the diagnosis and management of chronic pulmonary aspiration in children. Eur Respir J, 2006.PMID 17012631
- [2]Re GL, Vernuccio F, Di Vittorio ML, et al. Swallowing evaluation with videofluoroscopy in the paediatric population. Acta Otorhinolaryngol Ital, 2019.PMID 30933173
- [3]Gasparin M, Schweiger C, Manica D, et al. Accuracy of clinical swallowing evaluation for diagnosis of dysphagia in children with laryngomalacia or glossoptosis. Pediatr Pulmonol, 2017.PMID 27228428
- [4]Chang AB, Grimwood K, Boyd J, et al. Management of children and adolescents with bronchiectasis: summary of the ERS clinical practice guideline. Breathe (Sheff), 2021.PMID 35035559