Summary Writer: Jeffrey Duncan
Script Writer: John Farey
Editor: Amy Freeman-Sanderson
Interviewee: Amy Freeman-Sanderson
James talks to Dr Amy Freeman-Sanderson about the assessment of safety to eat in a person who is dysphagic or dysphasic.
Dr Amy Freeman-Sanderson is the Acting Head of the Speech Pathology Department at Royal Prince Alfred Hospital. She holds an honorary position at the University of Sydney. She has worked within the critical care setting both nationally and internationally, for over 15 years.
Amy has a particular interest in patients with a tracheostomy and completed her PhD studies in this area at the University of Sydney in 2016. The focus of her thesis was early communication intervention for restoration of voice and associated quality of life.
With Dr Amy Freeman Sanderson, Acting Head of Speech Pathology,Royal Prince Alfred Hospital, Sydney, Australia
Dysphagia is a common consequence of acute stroke with a reported incidence of 47% in the most recent national audit. Adverse events associated with early, inappropriate reintroduction of swallowing include aspiration pneumonia, dehydration and malnutrition. Whilst early assessment of stroke patients by a speech pathologist is a state-wide key performance indicator within NSW Health, it is recognised that many patients are admitted after-hours or on weekends to wards with limited speech pathology services. It is imperative nursing and medical staff are familiar with the swallowing difficulties experienced by acute stroke patients and feel comfortable screening patients for early re-introduction of food and fluid.
Case – You have a new patient, an 84-year-old female newly admitted with a dense right hemiplegia secondary to a stroke. A nurse on the ward is asking if she can eat and drink?
The patient spends a month in hospital, and despite strict adherence to a diet of extremely thickened fluids, she develops aspiration pneumonia. Eventually she is discharged to a nursing home with very poor mobility and requires a hoist for transfer. She is admitted to hospital several months later with another aspiration pneumonia.
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