On this episode of The Swallow Your Pride Podcast, Karli Negrin, MA, CCC-SLP, joins the show to talk about what happens when the clinical guidelines say one thing and the babies in front of you need another. Karli has spent nearly two decades in the cardiac intensive care unit at Nemours Children's Health working with infants with critical congenital heart disease. When she wanted to start using FEES with her breastfed post-op patients, her cardiac team asked for a literature review. She went looking and found almost nothing. So she and a multi-site team of cardiac SLPs, an aerodigestive chair, and a cardiac intensivist ran a survey of practice instead. What they found: 58% of responding centers are performing FEES in the CICU, 71% of those still prefer VFSS as their primary instrumental exam, and most are doing it without lesion-specific inclusion criteria or physiologic stopping parameters.

In this conversation, Karli breaks down why NICU feeding research doesn't transfer cleanly to term infants with cCHD, why aspiration risk shows up regardless of surgical STAT category or vocal fold mobility, how coupling FEES with the postoperative NPL could work (and where it gets complicated), and the research article on parental role alteration that changed the way she approaches every bedside. She also makes the case that you do not need a PhD to start collecting data on a clinical question you can't find the answer to.

Research source: Negrin K, Willette S, Godsil J, LaManna S, Garcia R, Morris K, Jones C, Morrow M, Wiscount J, Meyer-Macaulay C, Aaronson N, Reynolds J. Perioperative Management of Dysphagia Within the Cardiac Intensive Care Unit Utilizing Flexible Endoscopic Evaluation of Swallowing: A Survey of Practice. Am J Speech Lang Pathol. 2026 Mar 10;35(2):763-771. doi: 10.1044/2025_AJSLP-25-00100. Epub 2026 Feb 24. PMID: 41734216.

Show notes: https://syppodcast.com/409

On this episode of The Swallow Your Pride Podcast, Theresa Richard sits down with Lindsay Iser, M.S., CCC-SLP, Director of Clinical Specialty for Powerback Swallow Solutions, who leads one of the largest in-house mobile FEES programs in the country. Lindsay walks through how the program started with conversations before 2020, launched its first training in […]

The post 408 – Building Mobile FEES From the Inside: How One Company Trained Its Own Endoscopists appeared first on Swallow Your Pride Podcast.

On this episode of The Swallow Your Pride Podcast, Theresa sits down with Nicole Langton-Frost, CCC-SLP, BCS-S and Carey DeWalt, CCC-SLP from The Johns Hopkins Hospital to talk about something a lot of acute care SLPs have been told to skip: cognitive evaluation and treatment in the ICU. This conversation started because MedSLP Ed posted a question about whether cognitive rehab really has a place in acute care, and Nicole reached out to say her team wanted to weigh in.

Nicole Langton-Frost CCC-SLP, BCS-S and Carey DeWalt CCC-SLP walk through the research on multimodal sensory stimulation for patients with disorders of consciousness, the 2013 New England Journal of Medicine study showing 40% of ICU survivors still had cognitive function equivalent to a moderate TBI at three months, and a 2023 randomized controlled trial where just two 30-minute cognitive sessions a week produced significantly better cognitive scores. They also get specific about chart review: what head imaging tells you about cerebral small vessel disease and Fazekas scores, which lab values should make you postpone a standardized assessment, and how ejection fraction factors into cognitive risk. They cover which patients are and are not good candidates, why the answer is often compensatory strategies and caregiver training instead of restorative therapy, and how their department grew this practice one patient population at a time.

Get the show notes and references here: https://syppodcast.com/407

The post 407 – Cognitive Rehab Belongs in Acute Care: How One Hospital Built the Case Over 12 Years appeared first on Swallow Your Pride Podcast.