2013 Charleston Swallowing Conference
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1 Providing Quality Affordable Continuing Education and Treatment Materials for over 30 years Charleston Swallowing Conference Working Breakfast 7:30 8:00 am Saturday, Oct. 12, 2013 CE Seminars On-line CEUs Products Authors: Bonilha & Huda Facebook.com/NorthernSpeech 325 Meecher Road PO Box 1247 Gaylord, MI Phone: Fax:
2 PATIENT RADIATION EXPOSURES IN BARIUM SWALLOW EXAMINATIONS Walter Huda PhD Radiology and Radiological Science MUSC, Charleston SC Financial Disclosures Research Support (Siemens) Consultant/Contractor (Siemens) Book Royalties (LWW, MPP) President (Huda Physics in Medicine) Radiation Barium Swallow Studies Patients 1
3 RADIATION (IONIZING) All earthlings get ~ 3 msv/year 2
4 US Occupational dose limit: 50 msv/yr 1980 s 3.6 msv/year msv/ year 3
5 BARIUM SWALLOW STUDIES 3 to 4 minutes of Fluoroscopy Barium Swallow Effective Doses ~ 0.5 msv Chest CT ~ 5 msv How many chest x-ray examinations? 4
6 One chest CT ~ 100 chest x-rays One Ba Swallow ~ 10 chest x-rays Thyroid Cancer Risk vs Sex (40 year old) 8 per per 10 6 Thyroid Cancer Risk vs Age 40 years 8 per years 70 per years 0.6 per
7 PATIENTS Chances of no radiation induced cancer 8 per 10 6 ~ 999,992 per 1,000,000 US incidence ~ 42% US mortality ~ 22% 6
8 Radiation Risks Cumulative Total Lifetime Dose Latent period Decades (Thyroid Cancers).DAM Don t Order Tests that Don t Affect Management 7
9 Benefits > radiation risks As Low As Reasonably Achievable ALARA No Patient Dose Limits Eliminate Unnecessary Radiation Our Research Radiation exposure time during MBSS Pilot study of the influence of pulse rate R01 to address pulse rate and radiation 8
10 Radiation Exposure Time during MBSS Standardized protocol use (MBSImP ) Influence of swallowing impairment severity Medical diagnosis Clinician experience Bonilha, H.S., Humphries, K., Blair, J., Hill, E., McGrattan, K., Carnes, B., Huda, W., Martin-Harris, B. (2013). Radiation exposure time during MBSS: Influence of swallowing impairment severity, medical diagnosis, clinician experience, and standardized protocol use. Dysphagia, 28(1): Pilot Pulse Rate Study Differences in judgments from MBSImP and PAS between 30 and 15 pps Impact of judgment differences on treatment recommendations Differences in judgments from PAS between 30, 15, 7.5 and 4 pps Bonilha, H.S., Blair, J., Carnes, B., Huda, W., McGrattan, K., Humphries, K., Michaels, Y., Martin-Harris, B. (in press). Impact of pulse rate on measures of swallowing impairment severity: A preliminary study. Dysphagia. Current Research Aim 1. Quantify the impact of pulse rate on swallowing impairment severity assessment and treatment recommendations. NIH/NIDDK R01DK098222, Impact of Pulse Rate on Swallowing Impairment Assessment and Radiation Exposure, PI: Bonilha 9
11 Current Research Aim 2. Quantify radiation dose during MBSSs. Aim 3. Quantify the cancer risk based on radiation dose. NIH/NIDDK R01DK098222, Impact of Pulse Rate on Swallowing Impairment Assessment and Radiation Exposure, PI: Bonilha Thank You 10
2013 Charleston Swallowing Conference
Providing Quality Affordable Continuing Education and Treatment Materials for over 30 years. 2013 Charleston Swallowing Conference Session 9 Bedside Assessment: What Does It Tell You? 10:00 11:30 am Saturday,
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