Modified Mondays: Inconsistent Aspiration Response Video

Response to aspiration: It’s complicated

So, during the bedside swallowing evaluation, your patient has a strong and immediate cough with thin, a delayed and less severe cough with nectar, and no cough with honey thick liquids. A good sign that the patient didn’t aspirate the honey….or not? See this video clip for a great example of why a cough is just a cough and can’t be taken to be a reliable indicator of aspiration (and lack of a cough can’t be taken as a reliable indicator of no aspiration). The first bolus is thin, the second is nectar, the third is honey. Also, check out this link to a really interesting study regarding cough response to aspiration in various liquids: 

https://www.ncbi.nlm.nih.gov/pubmed/29845700