What is Mobile FEES?
FEES stands for flexible endoscopic evaluation of swallowing which is a procedure where a small, thin endoscope is gently passed through the nares to view the pharynx and larynx during swallowing. FEES is performed to assess swallow physiology and rule out aspiration. It is a procedure that allows the clinician to diagnose the reason for the patient’s swallow symptoms in order to come up with an individualized treatment which targets the patient’s deficits. Mobile FEES providers travel directly to the patient’s bedside to perform this specialized procedure.
There are many mobile FEES providers throughout the US. Here is a list of mobile FEES providers. NDoscopy Dysphagia Specialits provide mobile FEES throughout NY and NJ. Please contact us with any FEES requests or options for expanding the territory.
Why is Mobile FEES necessary?
Speech-language pathologists typically first assess a patient with a clinical bedside swallow assessment. This assessment is the first step to determine if a patient is at risk for aspiration and related sequelae. A detailed clinical bedside swallow assessment would include a detailed case history with the patient’s predisposing risk factors for dysphagia such as any neurological conditions, pulmonary disorders, head and neck cancers. Then the SLP will ask the patient questions related to the swallowing issue such as which consistencies are troublesome, a description of the issue and the length of time the issue has been occurring. A cranial nerve assessment of the nerves for swallowing are performed to determine if there are any other risk factors. Food and liquid trials are sometimes commenced at bedside if the clinician feels this is appropriate.
The clinical bedside swallow study is a signifiant part of helping to diagnose a patient’s dysphagia and determine the next steps or referrals needed. However, SLPs often over diagnose dysphagia when using a clinical bedside swallow study alone 70% of the time and missed aspiration happened in 14% of cases (Leder). If the patient is demonstrating difficulty with the oropharyngeal stages of swallowing, typically an instrumental swallow assessment is recommended. Instrumental assessments include a modified barium swallow study and/or a flexible endoscopic evaluation of swallowing.
Instrumental assessments can view the swallowing mechanism directly. FEES shows the structures and function of the larynx and pharynx. It provides information about the timing of the swallow, if there is any material left in the throat (residue) or if material entered the airway (aspiration). The information from a FEES can provide a more individualized treatment program. It demonstrates why the patient is having difficulty for a more targeted treatment program.
Benefits of Mobile FEES
Mobile FEES companies will typically advocate to get your facility the instrumental access that it needs. Here at NDoscopy, we will provide free inservicing on all the benefits of FEES to your administration. We will provide information on cost savings, patient safety, and quality of life. We have spoken with many administrators to get patients the care they deserve. Any facility that is in contract with us also receives free inservices on topics such as oral care, aspiration pneumonia, general aspiration precautions, tracheostomy and dysphagia, and Passy-Muir Valves for example.
For patients in a home setting, we come directly to the comfort of your home to provide our FEES services. Scheduling is easy! You can reach us at 646-389-4316 to get started. We just need a physician’s order for “FEES to r/o aspiration and assess swallowing.”
Mobile FEES provides patient care directly to the patient. No need for the hassle of transportation and costs associated. Mobile FEES can be provided in the most convenient location for the patient such as their bed, wheelchair or chair.
Our mobile FEES company provides quick access to an instrumental swallow study. Modified Barium Swallow studies and many other FEES providers can take weeks to schedule and then receiving the report can often take additional effort and time. Patient safety and quality of life are at risk. NDoscopy Dysphagia Specialists provide access to FEES within 1-2 business days of the consult with immediate results. A detailed report with images is provided and a video can be provided as well.