Breathing Digestionand Swallowing

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					                                                                                     BREATHING, DIGESTION AND SWALLOWING: BEST PRACTICES IN DYSPHAGIA MANAGEMENT
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                                                                                                                                                                                                                          q ROANOKE - February 23     q CHARLOTTE - February 24    q COLUMBIA - February 25
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              CROSS COUNTRY                                                                                                                                                                                           Breathing, Digestion and Swallowing: Best Practices
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                EDUCATION                                                                                                                                                                                             in Dysphagia Management                       #2419
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Breathing, Digestion
                                                                                                                                                                                                                                                                     strategies and discuss the effectiveness of each
                                                                                                                                                                                                                                                                     Evaluate the evidence for specific dysphagia management
                                                                                                                                                                                                                                                                                                                               dysphagia treatment
                                                                                                                                                                                                                                                                                                                               processes for children and adults, along with their impact on
                                                                                                                                                                                                                                                                                                                               Discuss common respiratory and gastrointestinal disease
                                                                                                                                                                                                                                                                                                                                                                                               aspiration pneumonia
                                                                                                                                                                                                                                                                                                                                                                                               Recognize which patients are most at risk for developing
                                                                                                                                                                                                                                                                                                                                                                                                                                                          treatment process
                                                                                                                                                                                                                                                                                                                                                                                                                                                          Identify common indicators of reflux and how they impact the
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         gastroesophageal systems
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         interrelationships between the respiratory and
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Examine new research detailing the development and
 Occupational Therapists, Dietitians, Respiratory Therapists and Dietary Managers.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Dysphagia Management
   Continuing education available for Nurses, Speech-Language Pathologists,

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          and Swallowing:
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Best Practices in
                                                                                                                         Charlotte, NC - February 24
                                                                                       Columbia, SC - February 25

                                                                                                                                                                                                              Richmond, VA - February 3
                                                                                                                                                       Roanoke, VA - February 23
                                                                                                                                                                                   Norfolk, VA - February 4

                                                                                                                                                                                                                                          Raleigh, NC - February 2
      Breathing, Digestion
        and Swallowing:
                   Best Practices in
               Dysphagia Management
Assessing the Interrelationships Between the Respiratory and
Gastroesophageal Systems
The American Speech-Language-Hearing Association estimates that more than 15 million people in the United States have dysphagia.
With dysphagia being that common, the need for an effective treatment plan is considerable. Furthermore, dysphagia is often correlated
with many other medical conditions, including gastrointestinal conditions, nervous system disorders and respiratory disorders. These
medical conditions can exacerbate the patient’s dysphagia and complicate the assessment process. Clinicians who fail to recognize the
interrelationships between the respiratory and gastroesophageal systems may be under-treating the patient’s condition.
This one-day seminar will help give clinicians a clearer picture of the respiratory and gastrointestinal systems, their relationship to each other,
and their impact on dysphagia management. Disease processes, with particular emphasis on aspiration pneumonia and gastroesophageal
reflux disease, will be discussed along with strategies for clinical management. Participants will leave the seminar with the skills to do a
thorough assessment and treat the whole patient, not just their symptoms.

What You Will Learn                                                                Who Should Attend
- Discuss the development and interrelationships between the                       -   Speech Therapists
  respiratory and gastroesophageal systems                                         -   Speech Therapy Assistants
- Assess the impact of respiratory and gastrointestinal functioning                -   Occupational Therapists
  on swallowing                                                                    -   Certified Occupational Therapy Assistants
- Identify respiratory and gastroesophageal disease processes for                  -   Rehab Managers
  which dysphagia is a symptom                                                     -   Directors of Nursing
- Assess the evidence to support various clinical assessment tools                 -   Nurses
  such as reflex cough testing, pulse oximetry, blue dye testing and               -   Restorative Nursing Staff
  cervical auscultation                                                            -   Dietitians
- Identify common indicators of reflux and how they impact the                     -   Dietary Managers
  treatment process                                                                -   Nursing Assistants
- Recognize which patients are most at risk for developing aspiration              -   Respiratory Therapists
- Determine when GER is actually GERD
- Compare and contrast the use of various airway management
- Evaluate the evidence for specific dysphagia management
  strategies and discuss their effectiveness

       “A much welcomed, practical, useful, ‘hands-on’ presentation.
        I am walking away with an arsenal of oral-motor techniques
          that I can use tomorrow. It was a very interesting course!”
                           Shawnie Maffett, SLP
                              Sugarland, TX
Course Director                                                            Dates & Locations
ANGELA MANSOLILLO, MA/CCC-SLP, is a Speech-Language                        RALEIGH - February 2, 2011
Pathologist and Board Recognized Specialist in Swallowing Disorders        Wyndham Hotel RTP-RDU Airport
with over 21 years of experience. She is currently a senior Speech-        4620 S. Miami Blvd., Durham, NC 27703 919-941-6066
Language Pathologist at Cooley Dickinson Hospital in Northampton,          RICHMOND - February 3, 2011
Massachusetts where she is involved in evaluation, treatment               Holiday Inn Richmond Airport
and program planning for adults and children with dysphagia. In            445 International Center Dr., Sandston, VA 23150 804-236-1111
addition, she is a clinical supervisor and adjunct faculty member at
Elms College Department of Communication Sciences and Disorders            NORFOLK - February 4, 2011
in Chicopee, Massachusetts. For over 15 years, she has worked in a         Hilton Norfolk Airport
variety of clinical settings, provided numerous regional and national      1500 N. Military Hwy., Norfolk, VA 23502 757-466-8000
presentations and served as guest lecturer at several colleges and         ROANOKE - February 23, 2011
universities throughout Massachusetts.                                     Holiday Inn
Ms. Mansolillo received her Bachelor of Arts degree in communication       3315 Ordway Dr., Roanoke, VA 24017 540-362-4500
from Rhode Island College in 1983 and earned her Master of Arts in         CHARLOTTE - February 24, 2011
Speech-Language Pathology in 1985 from the University of                   Hilton Garden Inn Charlotte Ayrsley
Connecticut. She is a member of the American Speech-Language-              1920 Ayrsley Town Blvd., Charlotte, NC 28273 704-970-5000
Hearing Association and is a member of Special Interest Division 13,
which focuses on swallowing and swallowing disorders.                      COLUMBIA - February 25, 2011
                                                                           Clarion Townhouse Hotel
                                                                           1615 Gervais St., Columbia, SC 29201 803-771-8711

 RESPIRATORY SYSTEMS                            RESPIRATORY DISEASE PROCESSES                        - blue dye studies
 u Overview of systems                          u Infant Respiratory Distress Syndrome (IRDS)        - enteral feedings
   - anatomy/physiology                           - symptoms                                         - tracheostomy
   - pulmonary function                           - treatment                                        - glucose oxidase reagent strips
 u The apneic signal                              - complications                                    - cervical auscultation research
 u Respiratory cycles                             - IRDS and feeding                                 - pulse oximetry
 u The relationship of coordination to          u Bronchopulmonary Dysplasia (BPD)                   - Reflex Cough Testing (RCT)
   aspiration                                     - symptoms                                            RCT and stroke
 u Laryngeal Chemical Responses (LCRs)            - treatment                                     u Airway protection techniques
 u Reflexive cough                                - prevention                                      - cuff management
                                                  - complications                                   - occlusion of tracheostomy tube
 GASTROESOPHAGEAL SYSTEMS                         - feeding                                         - decannulation
 u Overview of systems                            - nutrition                                       - speaking valve/Passy-Muir valve
   - esophageal function                        u Cardiac Impairment                                    Who is a candidate?
   - primary peristalsis                          - CHF                                                 contraindications
   - secondary peristalsis                      u Obstructive conditions                                oral/pharyngeal therapy
   - tertiary contractions                        - COPD                                          u Aspiration management
 u Barriers to reflux                             - bronchitis                                      - diet
 u Saliva swallows                                - CF                                              - oral care
 u Digestive acids                                - pulmonary function tests                        - environmental modifications
 u Constipation                                   - relationship to dysphagia
                                                u Restrictive conditions                          REFLUX MANAGEMENT
 REFLUX                                                                                           u UGI
 u Relationship to feeding disorders              - pulmonary function tests
                                                  - relationship to dysphagia                     u pH monitoring
 u Reflux mechanisms                                                                              u Esophagoscopy (with/without biopsy)
   - Transient Lower Esophageal Sphincter         - pneumonia vs. pneumonitis
                                                  - pneumonia-aspiration and otherwise            u Scintigraphy/Milk scan
      Relaxations (TLESRs)                                                                        u Clinical assessment
   - LES incompetence                             - neuromuscular diseases
                                                                                                    - children
   - anatomical abnormalities                   ASPIRATION MANAGEMENT                               - adults
 u GERD signs and symptoms                      u Artificial airways                              u Lifestyle modifications
 u When does GER become GERD?                     - ventilation and oxygenation                   u Diet modifications
 u Reflux, feeding and swallowing behaviors       - patient airway                                  - children
 u Relationship to dysphagia                      - airway obstruction                              - adults
 GI/RESPIRATORY RELATIONSHIPS                     - pulmonary toilet/access                         - diet and LES pressure
 u Pressure relationships and their effect        - naso/oropharyngeal airways                    u Medication
 u Asthma/gastroesophageal reflux                 - endotracheal intubation                         - antacids
    connection                                    - tracheostomy                                    - physical barriers
 u Allergens                                    u Tracheostomy vs. intubation                       - prokinetics
 u Respiratory congestion                         - advantages/disadvantages of intubation          - acid suppressants/histamine blockers
 u Laryngopharyngeal Reflux (LPR)                 - when to convert from ET to trach                - acid blockers/proton pump inhibitors
                                                  - why aspiration is common in                     - effects of acid suppression
 ASPIRATION                                          tracheostomies                                 - medications that increase reflux
 u Definition                                     - tethering effect                              u Positioning
 u Signs and symptoms                             - subglottic pressure changes                   u Medical/surgical interventions
 u Effects on the airway                          - cuff effects                                    - indications
 u How much aspiration is too much?             u Mechanical ventilation                            - fundoplication
 u Risk factors                                 u Assessment of aspiration                          - endoscopic procedures
 u Aspiration and oral hygiene                    - clinical assessment                                  stretta system
                                                  - instrumental assessment                              plicator device
                                                  - penetration-aspiration scale                         endocinch
                                                  - 3 oz. water test                                     enteryx injection
                                                                                                  CASE STUDIES
Our Guarantee                                                                 Continuing Education Credit
Cross Country Education is a national leader in high-quality educational      Nurses:
products and services for the health care industry. We have trained over      Cross Country Education, LLC is accredited as a provider
one million health care providers, managers, nurses, professionals and        of continuing nursing education by the American Nurses
key personnel through our seminars, conferences and study programs.           Credentialing Center’s Commission on Accreditation.
Our programs are guaranteed to improve the effectiveness and efficiency       This course is offered for 6 contact hours.
of participants. If you attend one of our one-day seminars or purchase an     Cross Country Education is an approved provider with the Iowa
audio product and do not receive the professional or business benefits        Board Of Nursing, approved provider #328. This course is offered
described in our literature, or have some other professional complaint,       for 7.2 contact hours. Cross Country Education is approved by the California Board
please let us know in writing within seven days and we will issue a credit    of Registered Nursing, Provider #CEP 13345, for 7.2 contact hours. Cross Country
voucher that you or anyone in your facility may use toward another            Education is an approved provider by the Florida Board of Nursing, provider
                                                                              #50-466. This course is offered for 6.0 contact hours.
one-day seminar or audio program. All returned audio products and
materials must be received in original condition before a replacement         Speech and Language Pathologists:
is issued. You may contact us at Cross Country Education, P.O. Box 200,
Brentwood, TN, 37024.

Audio Products
Audio products include a comprehensive CD recording (audiotape
available on request) and companion course manual. If you are
registered to attend this seminar, you may order a set of tapes/CDs at a
reduced fee. Pricing can be found on the registration form, along with
shipping and handling. All pricing given in US currency; please call for
international rates. You can order online at our website, by faxing or
mailing the registration form on this brochure, or by calling 800-397-0180    This course is offered for .6 ASHA CEUs (Intermediate level; Professional area).
or 615-331-4422. All material is under copyright; any duplication is
                                                                              Dietitians: This program has been approved for 6 CPE hours by the Commission
unauthorized without written consent from Cross Country Education.            on Dietetic Registration.
Products in stock will typically ship within 5-7 business days. Call for
availability.                                                                 Dietary Managers: This program has been approved for 6 general educational
                                                                              clock hours by the Certifying Board for Dietary Managers (approval #128946).

Confirmations & Cancellations                                                 Occupational Therapists, Occupational Therapy
                                                                              Assistants: Cross Country Education is an AOTA
Confirmations of registration are sent via email within three days of         Approved Provider of continuing education. This course is offered for .6 AOTA
                                                                              CEUs. The assignment of AOTA CEUs does not imply endorsement of specific
receipt in our office. If you have not received a confirmation, you           course content, products, or clinical procedures by AOTA. AOTA Educational level
may call our office at 800-397-0180 or 615-331-4422 to verify                 Introductory, Category 1: Domain of OT, 2: Occupational Therapy Process.
registration. Cancellations received at least five working days before the
seminar are refundable less a $20 administrative charge per registrant.       Respiratory Therapists: Application has been made to the American Association
                                                                              for Respiratory Care (AARC) for continuing education contact hours for respiratory
There is no refund for cancellations received later; however, a credit will   therapists.
be issued toward a future seminar or product order. Please note that
if you register and do not attend, you are still liable for full payment.     Other professions: This seminar qualifies for 6 continuing education hours as
Substitutions may be made any time. The expense of continuing                 required by many national, state and local licensing boards and professional
                                                                              organizations. Save your course outline and certificate of completion, and contact
education, when taken to maintain and improve professional skills, may        your own board or organization for specific filing requirements.
be tax deductible. Please contact your accountant for complete details.
                                                                              All professionals: In order to process continuing education, please bring the
Disclaimer: Any opinions, findings, recommendations or conclusions            appropriate license/certification number to the seminar.
expressed by the author(s) or speaker(s) do not necessarily reflect the       Amended certificates: Please note that the credit hours listed above are offered
views of Cross Country Education. Cross Country Education reserves the        by Cross Country Education and/or boards/associations for a full day’s attendance.
right to substitute a qualified instructor due to unforeseen circumstances.   In the event of late arrival and/or early departure, amended certificates indicating
Registrants will not receive a certificate until payment has been             the actual number of credit hours earned will be provided upon calling Cross
                                                                              Country Education.
received and course has been successfully completed. If payment is not
received ten (10) days prior to the seminar, the certificate may not be       ADA: If you require ADA accommodations, please contact Cross Country Education
present at the seminar. If your payment is returned marked NSF it will        at least two weeks before the seminar date so that arrangements can be made.
be re-presented electronically and a processing fee will be charged as
allowed by law.

Course Hours
Registration begins at 7:30 a.m. The seminar begins at 8:00 a.m. and
concludes at 3:30 p.m. Lunch is on your own from 11:30 a.m. to
12:30 p.m. For late arrivals or early departures, please see amended
certificate information under Continuing Education Credit.

                                                                                                                                Conference and Expo
        “She gave us a wealth of information regarding dysphagia!
          The group discussion added information and nuances.
  Excellent instructor! I would take another seminar from Ms. Mansolillo.”         July 28 - 30, 2011
                   Theodore Huryn, SLP, Harrisburg, PA                          

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