Bedside Swallow Evaluation

Bedside Swallow Evaluation

The Bedside Swallow Evaluation (BSE) is a clinical assessment used to evaluate a patient's swallowing function at the bedside. This evaluation is crucial for identifying dysphagia, assessing aspiration risk, and guiding appropriate interventions to ensure safe oral intake. The BSE involves a systematic assessment of various components of swallowing, including oral motor function, sensory awareness, and coordination of swallowing reflexes.

Patient Information

Name

Age

Gender

Medical Record Number

Date of Evaluation

Clinical Presentation:

Chief Complaint

Relevant Medical History

Observation

1. Oral Mechanism Examination

Yes

No

Lip Closure

Tongue Mobility

Palatal Elevation

Laryngeal Elevation

Presence of Oral Residue

2. Cough Reflex

Yes

No

Spontaneous Cough

ough After Swallowing

Ability to Clear Secretions

3. Voice Quality

Yes

No

Wet/Gurgly Voice

Hoarseness

Vocal Effort

4. Oral Sensation

Yes

No

Sensory Awareness

Gag Reflex

Ability to Detect Food in Mouth

Swallowing Trials

1. Liquid Consistency

Yes

No

Volume

Ability to Initiate Swallow

Presence of Coughing

Signs of Aspiration

2. Pureed Consistency

Yes

No

Texture Tolerance

Mastication Ability

Bolus Formation

Swallowing Coordination

3. Solid Consistency

Yes

No

Texture Tolerance

Mastication Ability

Bolus Formation

Swallowing Coordination

Overall Assessment

Overall Swallowing Safety

Recommendations/Interventions

Comment/Feedback

Provide any additional comments or feedback regarding the evaluation process or the patient's swallowing function.

[Evaluator's Signature Over Printed Name]

Evaluation Templates @ Template.net