Rationale and Comments

Dysphagia (difficulty swallowing) is a common disorder in patients who have had a stroke, occurring in 50% to 60% of acute stroke patients. It is associated with an increased risk of aspiration, pneumonia, prolonged hospital stay, disability, and death. Swallow screening is critical in the rapid identification of the risk of aspiration in patients presenting with acute stroke symptoms. Because formal swallowing evaluation is not warranted in all patients with acute stroke, the purpose of a swallowing screen is to identify those who do not need a formal evaluation and who can safely take food and medication by mouth. Formal swallowing evaluations can be completed in patients who don’t pass the initial screening.

Sponsoring Organizations

• American Association of Neuroscience Nurses, Society of Pediatric Nurses, & American Pediatric Surgical Nurses Association, Inc.

Sources

• Systematic review

Disciplines

• Neurologic

References

• Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870-947.
• Kenmuir CL, Hammer M, Jovin T, et al. Predictors of outcome in patients presenting with acute ischemic stroke and mild stroke scale scores. J Stroke Cerebrovasc Dis. 2015;24(7):1685-1689.
• Martino R, Maki E, Diamant N. Identification of dysphagia using the Toronto Bedside Swallowing Screening Test (TOR-BSST©): are 10 teaspoons of water necessary? Int J Speech Lang Pathol. 2014;16(3):193-198.
• Schepp SK, Tirschwell DL, Miller RM, et al. Swallowing screens after acute stroke: a systematic review. Stroke. 2012;43(3):869-871.
• Summers D, Leonard A, Wentworth D, et al. Comprehensive overview of nursing and interdisciplinary care of the acute ischemic stroke patient: a scientific statement from the American Heart Association [published corrections appear in Stroke. 2010;41(9):e563 {dosage error in article text} and Stroke. 2011;42(3):e357]. Stroke. 2009;40(8):2911-2944.