PURPOSE

This program provides an opportunity to develop an understanding of the FEES procedure and to gain experience interpreting FEES for the evaluation and management of oropharyngeal dysphagia. It is primarily aimed at experienced clinicians who evaluate and treat patients with dysphagia using fluoroscopy, but have limited or no experience with FEES. However, clinicians who are new to dysphagia and clinicians with a moderate degree of experience with FEES may also find the course useful.

COURSE OBJECTIVES

The participant will attain a basic level of competence in performing the protocol, interpreting the results of FEES examinations and using endoscopy to guide therapy for patients with dysphagia. With a guarantee of passing the endoscope at least 5 times, he/she will become familiar with handling the endoscope passing it into the hypopharynx, and manipulating the scope within and around the larynx to attain an optimal view. Those who are already performing FEES will advance their level of competence in scoring results and applying FEES to various patient populations.

LEARNER OUTCOMES

On conclusion of the program, participants will be able to:

Understand what can be visualized and understood about normal and abnormal swallowing from an endoscopic image.

Know clinical indications and risks for performing FEES.

Follow a protocol for administering a FEES exam.

Identify key structures, identify and interpret findings, and apply appropriate therapeutic interventions during the performance of a FEES examination.

Implement and adapt the FEES protocol for different patient populations and settings.

Know how to use endoscopy to manage patients with dysphagia.

Learn how to implement FEES into their employment setting.

Have an introductory level of skill in passing the endoscope safely & know how to position the scope to get an ideal view during the FEES exam.

SAMPLE AGENDA

Day One

8:00-9:15Anatomy and the normal swallow: endoscopic and fluoroscopic visualization.

9:15-9:30 Indications for FEES vs fluoroscopy

9:45-10:45 The FEES Protocols: Standard protocol, Ice Chip protocol, FEESST protocol.

10:45-12:00 Scoring the FEES exam Part 1: Identification of abnormal findings.

12:30-2:00 Scoring the FEES exam Part 2: Scoring systems, sample reports, and practice scoring.

2:15-3:30 Use of FEES to guide therapy & management of dysphagia. Incorporating therapy into the exam. Use of endoscopy as a biofeedback tool in therapy.

Day Two

8:00-12:00Hands-on practice passing the endoscope on other participants

12:30-1:30Using FEES with acute care and ICU patients

1:30-2:15Implementing FEES in your setting: training issues, billing

2:15-2:30Risks of endoscopy, infection control, and informed consent

2:45-3:30Case studies, practice scoring, use of FEES with different patient populations and settings

3:30-4:00Discussion & Wrap-up

Langmore FEES Course Team

Mike Walsh, M.Ed, CCC-SLP

Mike retired in 2005 as chief of audiology & speech pathology at the Boston VA Health Care System. He has over 30 years of teaching, research, and clinical experience, and he currently works on NIH funded research and as a clinical SLP at Boston Medical Center. No financial or nonfinancial relationship exists between Mike Walsh and the FEES procedure.

Rebecca Scheel, MS, CCC-SLP

Becky has 18 years of clinical experience as a SLP and specializes in dysphagia with all age groups. She currently works at Boston Medical Center conducting FEES in the acute care setting and is actively involved in NIH funded clinical research. No financial or nonfinancial relationship exists between Rebecca Scheel and the FEES procedure.

Edel McNally, MS, CCC-SLP

Edelhas 15 years of clinical experiencein both rehabilitation and acute care settings. She is currently a senior SLP at Boston Medical Center where she performs FEES. Edel is a guest lecturer at Boston University and is involved in clinical research at BMC. No financial or nonfinancial relationship exists between Edel McNally and the FEES procedure.

Susan Langmore PhD, CCC-SLP, BRS-S

Course director Susan Langmore developed the FEES procedure in 1988. Dr. Langmore is Director of Speech Language Pathology at Boston University Medical Center, Professor of Otolaryngology Head & Neck Surgery at Boston Medical Center, and Clinical Professor of Speech and Hearing Sciences at Boston University. She carries an active caseload at Boston Medical Center teaches at BU, conducts research, speaks on dysphagia nationally and internationally.No financial or nonfinancial relationship exists between Susan Langmore and the FEES procedure.

More about Dr. Susan Langmore

/ForPhysicians/Susan_Langmore.html

More about the Langmore FEES Course

This program offers 1.35 CEUs (Intermediate level, Professional area).

In order to perform the FEES procedure, proper training from experienced clinicians is needed. TheLangmore FEESCourse is an unparalleled introductory course taught by the creator of the FEES procedure and her team of expert clinicians. This course is aimed at clinicians who have little or no experience with FEES, and who want to incorporate this tool into their practice.

The course is offered quarterly at Boston University Medical Center. For more information or to register, please contact Peggy Belmonte at (603)702-1571 or . We look forward to seeing you at our next course!