Swallowing Screening Procedure

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Swallow difficulties are present in up to 60% of Stroke Patients on admission. The aim of intervention is to minimise complications and to establish a method of feeding that is acceptable to the patient and which allows for adequate intake while minimising the risk of aspiration, discomfort and choking. Every patient should be regularly reviewed. All patients presenting with stroke / suspected stroke should have a swallow screen completed. Speech and Language Therapists should be contacted to carryout a full assessment if the patient fails the screen.

Difficulty with solids?

Aspiring in patients with swallowing difficulties

Dysphagia affects a large proportion of stroke patients. Swallowing difficulties can result in aspiration and reduced oral intake. This can lead to complications and also has knock on effects for the administration of medication. If in any doubt the Hospital or Community Pharmacist should be consulted by the professional managing the patient’s Dysphagia.

What are the options for Administering Aspirin to Patients who are Nil by Mouth?

Aspirin can be given rectally (supps. 150mg or 300mg available) or by Enteral Tube using Soluble Aspirin (see below) using the recommended doses as described in Secondary Prevention Protocol.

Is Aspirin available in Soluble Form?

Yes, and comes in doses of 75mg and 300mg. The standard direction is to take it with food or a little milk.

What if an individual can only take Thickened Fluids?

The Soluble Form can be thickened usually with Yoghurt.

Contraindications?

All anti-platelet agents are contraindicated in patients with active peptic ulcers or risk of bleeding. Consider gastric protection if patient develops dyspepsia.

Who to contact?

If you require further advice about the Management of Dysphagia and are unable to get local support from a Speech & Language Therapist, please contact:
Sandra Hewitt – Clinical Specialist for SLT (Highland Stroke Services), Tel: (01463) 705424; Bleep 7117
For Further Information or Advice about Stroke Care Protocols:
Linda Campbell – Stroke Coordinator, Tel: (01463) 704086 or Radiopage: 07623894043
Visit the NHS Highland website for up to date information on Strokes, TIAs and Stroke Services across Highland including a copy of this advice note: www.show.scot.nhs.uk/nhshighland/healthservices

Editorial Information

Last reviewed: 31 March 2018

Next review: 31 March 2020

Author(s): Stroke Clinical Network

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Stroke Co-ordinator