How to assess for swallowing difficulty in stroke patients.

In Australia each year around 60,000 people will experience a stroke. Half of them will be over the age of 75. And with out rapidly ageing population it has been forecast that over the next 15 years there will be an 70% increase in the number people who will have a stroke. An national audit conducted in 2010 found that 47% of stroke admissions included a diagnosed dysphagia. These patients have an increased risk of aspiration, particularly within the first 72 hours. Most of us swallow around 2000 times a day in order to empty the saliva from our mouth, and intake nutrition & hydration. In fact this act of swallowing which we all take for granted, is a highly complex sequence involving precise muscle control. So complex, that over the 2–3 seconds it takes just to pass a food bolus from the back of the mouth to the stomach it requires assistance from the V, VII, IX, X, XI and XII cranial nerves. The process of swallowing can be divided up into 3 main phases. The preparatory or oral phase. In which food is chewed, mixed with saliva and packaged up into a bolus. The Pharyngeal phase. In which the soft palate elevates to occlude the nasopharynx. The tongue pushes the bolus backwards as the pharynx and larynx move upwards to greet it. The epiglottis tips down to seal the airway. Finally, a whole bunch of pharyngeal constrictor muscles generate a peristaltic action to guide the bolus into the oesophagus (gravity pays almost no part in this, which is why you could happily surv...
Source: impactEDnurse - Category: Nurses Authors: Tags: clinical skills Source Type: blogs