The investigators hypothesize that aspiration will be more prevalent at two to four hours post-extubation but will resolve in the majority of patients by 24 to 26 hours post-extubation.

The purpose of the research is to investigate whether there is a difference in swallow function two to four hours after extubation (removal of breathing tube) compared to 24 hours after extubation. This information will help healthcare providers decide if it is necessary for people to wait 24 hours after extubation before they start eating and drinking.

Inclusion Criteria:

• Patients that were intubated for more than 48 hours.
• Adults, 18 and over
• All races
• Males and females
• Approval to participate in the study by the treating physician

Exclusion Criteria:

• Patients with a history of oropharyngeal dysphagia.
• Patients with neurological disorders associated with dysphagia including dementia, Parkinson's disease, multiple sclerosis, stroke, and ALS.
• Patients with a history of head and neck cancer or laryngeal surgery.
• Patients that are not candidate for FEES because of facial fractures, nothing by mouth (NPO) status for other procedures, elevated bleeding risk (patients on therapeutically dosed anticoagulant infusion or injection, platelet count less than 50,000, INR greater than 2.0, partial thromboplastin time greater than 1.5 times normal), decreased level of arousal/alertness, significant agitation, or inability to tolerate room air or nasal cannula oxygen for duration of FEES.
• Patients who are extubated after 1400 or on weekends (Friday, Saturday, or Sunday).
• Non-English Speakers will be excluded

Intubated inpatients 18 years and older at the University of Wisconsin Hospital Trauma and Life Support Center.