What is speech therapy's availability?
Daily 8-4, weekends and holidays 8-12
What is Dysphagia?
Swallowing disorder
What is the purpose of swallow screening?
To assess for immediate risk of dysphagia in patients with possible stroke
Should patient remain NPO after passing nursing bedside swallow screening?
FALSE- if patient passes nursing screening, they may have a PO diet before evaluated by speech
What is the best way to contact a speech therapist?
Vocera or x5002
How common is dysphagia after a stroke?
It is one of the most common complications, with 20-25% of patients experiencing aspiration after a stroke.
How many parts does swallow screening have?
2. Pre dysphagia screening questions and PO trials.
Can screening be repeated?
No! If patient fails, they must remain NPO until evaluated by speech.
How long does speech therapy have to evaluate patients after receiving an order?
24 hours
What is the best way to give PO meds? (whole, crushed, etc)
Ask the patient! Sometimes people have trouble swallowing pills at baseline. It is usually easier to ask and try to set patient up for success.
What type of patient is the swallow screening used for?
Primarily CVA/TIA patients. However, it can be utilized in other situations where a swallow screening is appropriate.
Should you call SLP if you make a patient NPO?
If patient was previously on a diet and you make them NPO due to difficulty swallowing, please notify SLP.
What is an example of other services SLP can provide?
Speech, voice, language, cognition, speaking valve
Can patients eat with PEG tube or NGT?
Yes, if a PO diet is also recommended by speech therapy.
If you answer ‘yes’ to any pre-dysphagia screening questions , do you go on to administer ice/water?
No! Answering ‘yes’ is an automatic fail on the screening. I.e. if a patient has a facial droop, they automatically fail the screening.
Do you keep a patient NPO without changing the diet order?
No! We prioritize our patient's based on their diet order. If you are keeping a patient NPO due to swallowing concerns, please change the order to NPO so we are aware!
How do you find our recommendations?
We will most often give you our recommednations verbally. Our recommendations are also found in our notes under then ‘Notes’ tab in epic. Filter to “Rehab Therapies" for easier searching.
How does speech therapy evaluate dysphagia?
We complete a bedside clinical evaluation. We then may complete additional instrumental evaluation (VFSS or FEES)
How do you determine if patient tolerates ice/water trials?
If patient has coughing, choking, wet vocal quality(gurgling), trouble breathing, delayed swallowing, etc patient is considered to fail screening.
If facial droop is chronic, does the patient fail the screening?
Yes. It is difficult to asess for changes when a droop is chronic. Best practice would be to keep patient NPO until evaluated by speech.