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What should a swallowing therapist should carry in there bag for a session

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Here is a thorough, evidence-informed breakdown of what a swallowing therapist (speech-language pathologist/dysphagia specialist) should carry in their bag:

Swallowing Therapist's Bag - Complete Checklist

Assessment & Screening Tools

  • Pulse oximeter - monitors O2 saturation during swallowing trials; a drop of ≥2% can indicate aspiration
  • Stethoscope (flat diaphragm) - for cervical auscultation; placed on the side of the thyroid cartilage to amplify swallowing sounds (release of subglottic air, epiglottic movement)
  • Penlight or small torch - oral cavity inspection
  • Tongue depressors - oral motor exam, cranial nerve testing
  • Gauze squares - tongue protrusion testing, bolus control
  • Gloves (nitrile/non-latex) - essential for any oral exam
  • Face mask
  • Graduated measuring cup or syringe - for controlled water swallow tests (e.g., the 30 mL or 100 mL Water Swallow Test, which has validated cut-offs for predicting aspiration risk) - Scott-Brown's Otorhinolaryngology, p. 825
  • Timer/stopwatch - WST measures swallowing speed, capacity, and volume

Validated Outcome Measures & Forms

  • EAT-10 (Eating Assessment Tool - 10) - patient-reported dysphagia severity
  • GUSS (Gugging Swallowing Screen)
  • MASA (Mann Assessment of Swallowing Ability)
  • Functional Oral Intake Scale (FOIS) - quantifies level of oral intake
  • Performance Status Scale for Head & Neck Cancer (PSS-HN)
  • Minimal Eating Observation Form (MEOF-II) - validated mealtime observation tool (especially useful for dementia/learning disability patients)
  • Penetration-Aspiration Scale (PAS) reference card
  • Blank progress/SOAP note forms or tablet/clipboard

Food & Liquid Trial Supplies

  • Thickening agent (xanthan gum-based, e.g., Resource ThickenUp Clear) in levels matching IDDSI framework (Levels 0-4)
  • Cups (small, 30 mL and standard size)
  • Teaspoons and tablespoons
  • Straws (standard and cut straws for controlled sipping)
  • Soft food samples - crackers, puree pouches, soft biscuits
  • Water (small sealed bottle)
  • 60 mL syringes - for bolus delivery in patients with limited lip closure

Oral Motor & Therapy Tools

  • Tongue depressors (standard and padded) - resistance exercises
  • NUK brush or oral stimulation kit - sensory stimulation
  • Chewy tubes (various resistances) - jaw strengthening
  • Vibrating oral stimulator (e.g., Z-Vibe) - thermal-tactile stimulation
  • Bite blocks - jaw stability training
  • Small hand mirror - patient biofeedback on facial/mouth movement

Safety Supplies

  • Suction catheter or portable suction unit (or know exact location of unit suction in clinical area)
  • Emesis basin/sick bowl
  • Extra gloves, masks, apron - full PPE for aerosol-generating scenarios
  • Hand sanitizer
  • Paper towels and wet wipes

Patient Education Materials

  • Printed handouts on:
    • Safe swallowing postures (chin tuck, head rotation/tilt, supraglottic swallow technique)
    • IDDSI food and liquid texture descriptions
    • Compensatory strategies
  • Visual diagrams of swallowing anatomy and stages
  • Carer feeding guidance sheets

Documentation & Admin

  • Tablet or printed forms for charting
  • Pens, markers
  • Referral pad for instrumental assessment (MBSS/FEES) when clinical exam is insufficient to rule out silent aspiration

Notes on Setting

SettingExtra Considerations
Acute hospitalKnow suction/crash trolley location; shorter sessions; NPO status common
Skilled nursing facilityMealtime observation tools (MEOF-II); carer training materials
PaediatricsNUK brushes, chewy tubes in smaller sizes, different food textures, parent handouts
Home visitsSelf-contained kit; portable suction if high-risk patient; phone for tele-consult
Key clinical note: A bedside clinical swallowing evaluation (CSE) is a screening tool. The combination of abnormal voluntary cough, absent gag reflex, dysarthria, dysphonia, post-swallow cough or voice change raises aspiration sensitivity to 92% - but silent aspiration cannot be confirmed without instrumental assessment (MBSS or FEES). Always have a clear referral pathway ready. - Scott-Brown's Otorhinolaryngology Head & Neck Surgery, p. 825

Create a checklist PDF I can print for session prep

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Your checklist PDF is ready to download and print:

Swallowing Therapist Session Checklist

PDF Document · PDF

What's included in the PDF:
  • Session header strip - fill in Date, Patient/Client, Setting, Clinician before each session
  • 6 numbered sections with tick-box checkboxes:
    1. Assessment & Screening Tools (pulse ox, stethoscope, WST supplies, etc.)
    2. Validated Outcome Measures & Documentation (EAT-10, GUSS, MASA, FOIS, FEES/MBSS referral forms)
    3. Food & Liquid Trial Supplies (IDDSI-aligned thickeners, cups, spoons, syringes, food samples)
    4. Oral Motor & Therapy Tools (NUK brush, chewy tubes, Z-Vibe, etc.)
    5. Safety Equipment (suction, PPE, emesis basin)
    6. Patient Education & Carer Materials (posture handouts, IDDSI guide, strategy sheets)
  • Clinical reminder box at the bottom - escalation criteria for aspiration risk (sensitivity/specificity data from Scott-Brown's Otorhinolaryngology)
It's formatted for A4 paper with clean teal headers and alternating row shading for easy reading at a glance.
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