The Penetration-Aspiration Scale can be used in the assessment of patients with dysphagia at risk for aspiration.
Dimension 1: depth of invasion of bolus into the airway
(1) bolus does not enter airway
(2) bolus enters larynx but stays above the vocal folds
(3) bolus enters the larynx to the level of the vocal folds
(4) bolus passes below the vocal folds
Dimension 2: swallower's response to bolus
(1) completely expelled
(2) partially expelled
(3) not expelled
|
Airway |
Vocal Folds |
Ejection |
Point |
|
material does not enter |
|
|
1 |
|
material enters |
remains above |
ejected from airway |
2 |
|
material enters |
remains above |
not ejected |
3 |
|
material enters |
contacts vocal folds |
ejected from airway |
4 |
|
material enters |
contacts vocal folds |
not ejected |
5 |
|
material enters |
passes below folds |
ejected from trachea into larynx or out of airway |
6 |
|
material enters |
passes below folds |
not ejected from the trachea despite effort |
7 |
|
material enters |
passes below folds |
no effort made to eject |
8 |
Interpretation:
• minimum score 0
• maximum score 1
• the higher the score the greater the severity of the dysphagia and risk of aspiration pneumonia
Specialty: Pulmonology
