The Beneficial Effects of SSA in the Detection of Dysphagia in Acute Stroke

TABLE OF CONTENTS ABSTRACT .1

1 . INTRODUCTION .2

Problem and its background .2

Setting of the study .2

Scope and limitation .3

Health and clinical management .3

2 . LITERATURE REVIEW

Acute stroke .5

Risks of dysphagia .5

Assessment of swallowing .6

Clinical Bedside Assessment .6

Gag reflex .7

Nasal endoscopy .7

Fluoroscopy .7

Pulse Oximetry .8

FEES .8

Water swallow test .9

Other Methods .9

Drawbacks of Swallowing test

.9

SSA .10

3 . METHODS

Patient selection .13

Clinical Assessments .13

Analysis and implication .15

Clinical and related professional involvement .16

4 . RESULTS .17

5 . DISCUSSION .22

6 CONCLUSION .24 REFERENCES .26

LIST OF TABLES

1 . Patients referred to SLT on day 1 of admission and have Safe or Unsafe swallowing by using SSA / Patients referred for communication assessment only /Not referred to SLT .31

2 . Pre-intervention phase : Comparison of SSA on days 1 and 7 with restricted and unrestricted feeding to see how many patients have safe or unsafe swallowing .32

3 . Post-intervention phase : comparison of the SSA on days 1 and 7 with oral feeding restrictions in use on day 7 .33

APPENDIX A . Dysphagia Screening Test . Staff Swallowing Assessment (SSA .34 ACKNOWLEDGMENTS

Many professionals contributed to the completion of this research effort . I would like to thank my supervisor Professor David Howard Degree Programme Director of School of Education Communication and Language Sciences in the University of Newcastle in United Kingdom . He extended my knowledge of statistical analysis and design issues . My thesis committee has been flexible , informative , and extremely helpful I would thank Dr . HYPERLINK "https /owa .ncl .ac .uk /Exchange /a6906223 /Inbox /Out 20of 20Office 20AutoR eply 20Hi .EML ?cmd editrecipient Index -1 " \o "d .m .james newcastle .ac .uk " Deborah James , Dr . Nick Miller and Ms Gillian Cavagan , the Office Manager of my school department . I am grateful for the efforts of Drs . Essam Al- Zimaity , the head of the ENT Department in King Khalid , National Guard Hospital in Jeddah Saudi Arabia for his help and for letting me collecting the data . I am also thanking Dr . Ashraf Abu aliz , the speech-language pathology consultant and all my friends and colleagues for their help and support they have been the front line in this effort . I am thanking the Neurology department in King Khalid Hospital , especially the nurses and the clinical nutritionist for their help

ABSTRACT

Dysphagia , or problems with swallowing , is common after acute stroke , and there is a risk of aspiration pneumonia and other complications . The early detection of dysphagia in such patients reduces such complications , hospital stay , and overall healthcare expenditures The objective of this study was to detect and manage dysphagia in the first few days after stroke by formal swallowing assessments . A pre- and post-intervention study was performed using a standardised bedside swallowing assessment (SSA ) at the neurology ward in King Khalid National Guard Hospital Jeddah , Saudi Arabia . The ethical committee of the hospital approved the study . Pre-intervention is before administration of the SSA , and post-intervention is after the SSA

The...