Top of page VFSS Protocol The VFSS protocol can vary from facility to facility, and from clinician to clinician, but a standard protocol focused on oropharyngeal swallow physiology assessment with an eye toward possible management of pathophysiologies is the goal. For example, in the Battle of Okinawa, bombardment and other combat operations reduced a lush tropical landscape into "a vast field of mud, lead, decay and maggots".