A new piece of equipment based at Noble's Hospital is making a 'massive difference' for patients who have trouble swallowing.
The video nasopharyngoscope allows healthcare professionals to see and record action in real time to identify issues.
Siobhán Fletcher speaks to Duncan Brown, the Clinical Lead of the Adult Speech and Language Therapy Service and Malcolm Clague from the Henry Bloom Noble Healthcare Trust to find out more.
Hello, good afternoon, my name's Duncan Brown and I'm the clinical lead for the Adult Speech and Language Therapy Service for the Ireland Man. So we're talking today about a new piece of equipment which I'm not going to try and pronounce, I'm going to let you do that. So can you tell me what it is and what it does? Yeah, so I'll do my best. It's a video, nasopharynge scope. Say that 10 times fast. Video, nasopharynge scope. So go tell me about it then, what does it do? So this is a system that allows us to look at somebody's swallow. So what we do is we place a small tube at the back of somebody's nose and then we shine the light down which illuminates the inside of somebody's throat. And while we're doing that, the images are then relayed back onto a screen. So we can give people something to eat and something to drink. And then we can watch as it goes down and we can record it and then we can play it back in slow motion. And the reason we do that is because swallowing is incredibly quick. It takes less than a second to swallow. And so what sorts of illnesses would you be looking at with this? Does it help diagnose, I suppose? Yeah, so normally we take swallowing for granted. So we swallow maybe 500 times a day. And when it goes wrong, we know it goes wrong because we cough or we clear our throats. Now when people get ill, there's this very gray area called silent aspiration. And what silent aspiration is is when things go down the wrong way but we don't get the cough, we don't get that clearing. And what this does is when somebody has, for example, something like a stroke or they might have a progressive illness like motor neuron disease. This can affect the swallow, this can affect the protective mechanisms. And so then people want to, who might want to eat and drink, we may end up, you know, people may end up noticing if they're getting a chest infection. And so we have to then check to make sure that things aren't going down the wrong way. And then, you know, if you use this equipment and you can see there's an issue, I suppose that then leads to, you can make these diagnosis and does it help? Maybe if you, before they're using this machine, you don't quite know what's going on with them. Yeah, so this might, we might go on to the ward, so we might go on to the intensive care unit. We might go on to the stroke ward and there are patients there that may have been placed what's called a nill by mouth so they're not able to have anything to eat and drink. And then we're asked to come on to see and evaluate on the ward what's happening with that person's swallow. And it's really useful for the whole staff, consultants, doctors, nurses, as well as the speech therapist to see what's happening. And then we can make a decision in the best interest of that patient and inform their care as well. And so is this a brand new piece of equipment for you? Is it an upgrade on something you previously had? You know, we'll mention the trust this is funding here. So what does this mean as well? Is this an upgrade or is it new? So we are incredibly grateful to the Henry Bloom Trust for providing this piece of equipment for us. It's a new piece of equipment and it's a standard of service that is offered across and we didn't have it here. And it's a gold standard of assessment. So to have this piece of equipment is really useful. And it's been a real game changer for our service and for investigating people who have swallowing difficulties. How long has it been in service? I mean, do you have a sort of average-ish number of how many patients this has already helped or how many think it will help in the future? That's a really good question. So we secured the funding in November last year and we started it a slow rollout in January. Of this year, it's becoming more and more used. We'll probably see maybe two, three, four patients per week. Which might seem like small numbers, but actually it makes a big difference to people's swallowing decisions. And some people might stay without having anything to eat and drink until we can get in and do these assessments. And does it speed up the process then I suppose if you, for the patient, is this affecting patient outcomes then? Yes, it does. So for example, somebody who may have a stroke, for example, if we're not sure if we've reached that grey area of silent aspiration and we don't know whether or not they might be, something might be going down the wrong way or not, we can get in at this early stage and make that decision to say yes they're safe to have something to eat. And we might modify their diet or we might modify their drinks in order to make it safer as well. So it reduces the risk and it gives more certainty about how that person is swallowing. Okay, first of all then Malcolm, can you introduce yourself for me? Alright, I'm Malcolm Clegg. I'm a trustee and medical assessor for the Henry Boom Noble Healthcare Trust. And we're talking today about another piece of quite exciting equipment that the trust has facilitated buying up at nobles. Can you tell me a little bit about it and I suppose why the trust wanted to buy this piece of equipment? Well, Henry Boom Noble Healthcare Trust originally set up nearly 135 years ago. And at that time Henry Boom Noble was interested in buying a hospital to improve the care for patients. Henry Boom Noble Healthcare Trust continues that by buying equipment that is suitable and appropriate for the future, not just for today. And certainly the equipment that was purchased was in a sense to my mind as a former surgeon, mind-blowing. Because it enables the clinicians to show patients, nurses and relatives what's going on in the back of their relatives throat who can't swallow quite properly. Nothing like that's been brought forward before. Yeah, and sort of speaking to the doctors up there as well, this is going to have big impact on patient care. It already kind of is. Like you say, it's the most bizarre thing. You sort of see even the vocal cords and everything moving. It's to show, you know, and save swallow and why it's unsafe. So why this piece of equipment did they reach out to you that they needed it? Or was it something that the trust sort of became aware that we didn't have at the hospital? The way the trust works largely is that healthcare people approach the trust through our website. And I go along and have a look and see if it's something that's likely to interest the trustees. If it is, I'll produce a very short paper presented to the trustees and if they say yes, we buy the equipment. And you've sort of been, you buy all the equipment, you're also supporting other schemes now as well. So, you know, things that are outside of the healthcare scheme, but support it. So what sort of is the logic then for what the trust approves and what it doesn't and what sort of outreach you're trying to do now? Well, what we're trying to do is help smaller healthcare charities, if you like, that have been struggling a little bit financially to buy equipment that they require to help their charity to continue. So we'd like to support charities that are doing good work on the island here. And without them, there would be a blank space in our healthcare system. And we also like to encourage people who work on the island in the healthcare side of things to gain further qualifications, and we will provide, for example, 50% of their training costs. Much of that training cost involves simply these days being online costs, providing they continue to work for the healthcare system on the island for two years after they've completed the course. So it's helping the healthcare system on the island by helping people move up the ladder, gain more qualifications, get better at doing the job they love to do without having to go somewhere else to do it. Thank you for making it the end of the Manx Radio Newscast. You are obviously someone with exquisite taste. May I politely suggest you might want to subscribe to this and a wide range of Manx Radio podcasts at your favourite podcast provider, so our best bits will magically appear on your smartphone. Thank you. [Music] (gentle music) [BLANK_AUDIO]
