Edmiaston et al reported the Acute Stroke Dysphagia Screen to screen a stroke patient for evidence of dysphagia. This can help to identify a patient who may be at risk for aspiration. The authors are from Barnes Jewish Hospital and Washington University in St. Louis.
Patient selection: stroke patient
Parameters:
(1) Glasgow coma score (GCS)
(2) facial asymmetry or weakness
(3) tongue asymmetry or weakness
(4) palatal asymmetry or weakness
(5) signs of aspiration associated with drinking 3 ounces of water
|
Parameter
|
Finding
|
Points
|
|
Glasgow Coma Score
|
13 to 15
|
0
|
|
|
<= 12
|
1
|
|
facial asymmetry or weakness
|
no
|
0
|
|
|
yes
|
1
|
|
tongue asymmetry or weakness
|
no
|
0
|
|
|
yes
|
1
|
|
palatal asymmetry or weakness
|
n0
|
0
|
|
|
yes
|
1
|
score =
= SUM(points for the first 4 questions)
Interpretation:
• minimum score: 0
• maximum score: 4
If the score is 0 then the 3 ounces of water drinking test is performed
Signs of aspiration may occur up to 1 minute after the test and include:
(1) throat clearing
(2) cough
(3) change in voice quality
If the score is 0 and if there is no sign of aspiration then the patient can be started on a regular diet.
If there are signs of aspiration then the patient is referred to speech therapy.
