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Finding Dysphagia in Four: A simple swallow screen

1 September 2022

The signs and symptoms of dysphagia are familiar to Speech and Language Therapists/ Pathologists and Dietitians that see dysphagia patients daily.

However, as you know, outside this sphere there are a huge number of health care professionals that are not. They may be unaware of how dysphagia can impact a patient’s recovery care plan. As a result, a patient may not be receiving the most suitable care.

As you know, dysphagia affects the elderly and with an increasingly elderly population, the incidence of dysphagia will only increase. It would therefore be a good idea to create a simple way to find dysphagia, for those on Acute wards and working in Surgeries and Health centres.

This is something highlighted in a paper we recently read: A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems?

You can read the full paper here: but to summarize…

“Screening for dysphagia is considered good practice on a stroke ward and for stroke care. However, despite it occurring at the same frequency in frail older adults on an Acute ward, it isn’t screened for.

When you consider that, in addition to strokes, there are 126 conditions that can present with dysphagia as a secondary symptom in older, frail patients, many may have a swallowing difficulty undiagnosed.

There is, therefore, a need to empower frontline medical and nursing staff to screen prior to referral rather than assess peoples’ ability to swallow when they are on the ward.

Consequently, the Paper’s authors reviewed the available literature on screening, other assessment techniques (EAT-10) and conducted a study to develop a shorter swallow screen, the 4 Question Test. (4QT).

This Swallow Screen is highly sensitive but not a specific swallow screen.

It does not replace a Speech and Language Therapists/Pathologists Assessment and does not aim to identify the nature or etiology of any dysphagia present.

Instead, it provides an effortless way for medical and nursing staff, without prior training, to identify people who may have difficulty swallowing and then, if necessary, refer them for a full swallow assessment.

There is the added advantage that, in clinically busy settings and out of hours, there is no need to look for a teaspoon or to establish the time taken to swallow a fixed volume of water.

This Swallow Screen is simple and effective. It does not pretend to be conclusive in identifying the presence of dysphagia. It empowers healthcare professionals to look for it before referring to a Speech Therapy Department.”

We think this is so important and could have a such a huge positive impact on helping dysphagia patients we have sponsored the printing of the cards you see above.

If you think it is important too and want to try them with your colleagues on the ward or in the Community, we will send you some. Just email and let us know how many you need.

All we ask is that you let us know how useful you found them. We will then forward your comments to the authors.

In the meantime, to read the paper in full just click this link:

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