MDCalc

Barnes Jewish Hospital Stroke Dysphagia Screen

Assesses ability to swallow without aspiration after stroke.

Screening Questions

GCS < 13
Facial asymmetry/weakness present
Tongue asymmetry/weakness present
Palatal asymmetry/weakness present

If ALL screening questions are answered NO, proceed to the 3 oz water test.

Any signs of aspiration during 3 oz water test

Result:

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Advice
  • If a patient completes all components of the BJH-SDS successfully then they can be safely started on a regular diet without the need for evaluation by speech pathology.
  • When evaluating a patient who suffered an acute stroke for potential dysphagia and aspiration risk, the BJH-SDS can be performed by non-specialty trained health care providers to determine which patients can safely tolerate a normal diet and which patients should be referred to speech pathology.
Critical Actions
  • The BJH-SDS appears to be an easy, reliable and efficient means for non-specialists to identify which patients can be safely advanced to a regular diet after suffering an acute stroke.
  • If for any reason there remain concerns that a patient may be an aspiration risk despite having a negative BJH-SDS evaluation, they should be referred to speech pathology before advancing their diet.