Dysphagia and speech pathology involvement in children admitted to hospital post-chemical ingestion injury

Abstract

Purpose: Dysphagia is common following pediatric chemical ingestion injury, yet there is a lack of data relating to recommencement of per os (PO) intake, or extent of speech-language pathology (SLP) involvement. The aim of the current study was to present characteristics of dysphagia and SLP management to inform future multidisciplinary management, care pathways, and referral practices. Method(s): Data were collected from 51 cases of chemical ingestion injury, (26 males), aged 2-170 months (mean 31.2), admitted to a tertiary paediatric care facility from 2008 to 2013. Clinical parameters relating to injury presentation, PO intake milestones, and extent of SLP involvement during the acute admission were examined. Result(s): Thirty-one children (60 %) experienced altered PO intake. Only 5/31(16 %) resumed normal PO intake during admission. At discharge, 16/31 (52 %) had modified PO intake, and 10/31 (32 %) remained nil PO (NPO). Six of the 31 (19 %) children with altered PO intake were referred to SLP during admission. Children referred to SLP were more likely to require paediatric intensive care admission (PICU) (100 % vs. 26 % for those not referred), and had longer hospital admissions (36.1 days vs. 9.3 days for those not referred). Conclusions (Including Clinical Relevance): Despite significant delay in recovery of PO intake milestones, referral to SLP was low. Increased SLP involvement could assist swallowing rehabilitation, modified PO intake progression, safety, and quality of life, for children with ingestion injury and their families.L6134350062016-12-01 <br />