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[Dysphagia] Dysphagia Screens for Nurses: Stroke Center
Hi Margie
Here's a website that has a dysphagia screen that is being used here in West
Australia
http://www.health.wa.gov.au/safetyandquality/TASC_WA/clinical/index.cfm
This may be a useful article for you
Ramsey, D.J., D.G. Smithard, and L. Kalra, Early assessments of dysphagia
and aspiration risk in acute stroke patients. Stroke, 2003. 34(5): p.
1252-7.
BACKGROUND AND PURPOSE: Dysphagia is common after stroke and is a marker of
poor prognosis. Early identification is important. This article reviews the
merits and limitations of various assessment methods available to
clinicians. METHODS: An electronic database search was performed of MEDLINE,
EMBASE, and the Cochrane database using such terms as stroke, aspiration,
dysphagia, and assessment; extensive manual searching of articles was also
conducted. RESULTS: Bedside tests are safe, relatively straightforward, and
easily repeated but have variable sensitivity (42% to 92%), specificity (59%
to 91%), and interrater reliability (kappa=0 to 1.0). They are also poor at
detecting silent aspiration. Videofluoroscopy gives anatomic and functional
information and allows testing of therapeutic techniques. However,
swallowing is assessed under ideal conditions that are different from
clinical settings, and reliability is often poor (kappa=0 to 0.75) in the
absence of assessor training. Fiberoptic endoscopy allows swallow assessment
and sensory testing but requires specialized staff and equipment. Oxygen
desaturation during swallowing may be predictive of aspiration (sensitivity,
73% to 87%; specificity, 39% to 87%) but is more useful in combination with
bedside testing than in isolation. Other methods of swallow testing are
invasive and require specialized staff and equipment. CONCLUSIONS: Although
bedside tests remain an important early screening tool for dysphagia and
aspiration risk, further refinements are needed to improve their accuracy.
Regards
Claire Langdon
----- Original Message -----
From: <mfriedman@bellsouth.net>
To: <dysphagia@b9.com>
Sent: Saturday, May 14, 2005 1:02 PM
Subject: [Dysphagia] Dysphagia Screens for Nurses: Stroke Center
> Our hospital is applying for the Stroke Center status and currently
developing the nurse delivered dysphagia screening form. Does anyone have
suggestions/forms to share? We are looking at some with use of a bedside
water test, etc. Reply to my personal address, if this has been covered
before, so as not to bore others.
> Thanks in advance for your assistance.
> Margie Wells-Friedman, MS, CCC
>
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> Dysphagia mailing list
> Dysphagia@b9.com
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