Which statement best describes the super-supraglottic swallow technique?

• A. Involves holding breath, bears down, swallows, coughs immediately after swallow, and swallows hard again
• B. Involves holding breath and coughing without swallowing
• C. Involves a single, unassisted swallow with breath held
• D. Involves holding breath, bears down, swallows, coughs immediately following swallow, and immediately swallows hard again

Answer: (D)

The super-supraglottic swallow is designed to maximize airway protection by actively closing the laryngeal entrance before and during the swallow. The sequence involves holding the breath with a bearing-down effort to tighten the laryngeal structures, then performing a swallow. Immediately after the swallow, you cough to clear any material from the airway, and you then perform an additional swallow right away to ensure complete clearance and continued protection. This exact combination—breath hold with effort, a swallow, a post-swallow cough, and an immediate second swallow—best describes the technique. Other descriptions miss one of these essential steps, such as the required breath-hold bearing-down, the immediate post-swallow cough, or the extra swallow after coughing.