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    Barnes Jewish Hospital Stroke Dysphagia Screen

    Assesses ability to swallow without aspiration after stroke.
    When to Use
    Pearls/Pitfalls
    Why Use

    The BJH-SDS can help non-speech pathologists identify stroke patients who are at risk for dysphagia and aspiration, allowing some patients to eat earlier while still preventing aspiration risks.

    The Barnes Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) was designed to create a simple dysphagia screen that health care professionals could use to detect swallowing difficulty in stroke patients quickly and accurately.

    • Specifically designed to be reliably used by practitioners who were not trained speech pathologists.
    • The BJH-SDS has been shown to be sensitive for detecting dysphagia and aspiration risk (94% sensitive/66% specific dysphagia; 95% sensitive/50% specific for aspiration).

    Points to keep in mind:

    • Some patients with normal swallowing function will have a delay in resuming a normal diet while they wait for evaluation by a speech pathologist, because of the rule’s low specificity.
    • In the original validation study there was a 24 hour gap between applying the screen and the and the gold standard: evaluation by a speech pathologist.

    There are nearly 800,000 cases of acute stroke in the United States every year, with 130,000 associated deaths (4th leading cause of death in Americans).

    Between 37-78% of acute stroke patients are affected by dysphagia (depending on the study) and these patients have been shown to be at an increased risk of aspiration, which is associated with increased rates of pneumonia, higher morbidity and mortality.

    The BJH-SDS can simply and reliably allow non-speech pathology trained healthcare professionals screen for patients with dysphagia or aspiration risk.

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

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Mr. Jeff Edmiaston

    About the Creator

    Jeff Edmiaston, MS, CCC-SLP is a clinical researcher based in St. Louis, MO at the Barnes Jewish Hospital Stroke Center. His research is focused on understanding the effect of stroke and critical illness on the human swallow mechanism and on clinical decision support tools which allow clinicians to make more accurate predictions for recovery and develop effective methods of treatment.

    To view Mr. Jeff Edmiaston's publications, visit PubMed

    Are you Mr. Jeff Edmiaston? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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