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In many hospitals, stroke patients routinely undergo formal swallowing assessments by speech pathologists. Because such assessments are not always readily available, researchers in an urban emergency department (ED) tested a simple physician-implemented dysphagia screening protocol.
Eighty-four stroke patients were screened by ED physicians at an average of 2.3 hours after they presented to the hospital. Patients who had swallowing complaints, abnormal voice quality, facial asymmetry, or aphasia were considered to have “failed” the first-tier screen. Those who passed the first screen were given 10 mL of water in cups without straws; patients failed the swallowing test if they experienced choking, coughing, or changes in voice quality while d…