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Fluids & Electrolytes
Nurses can routinely perform a simple bedside test that quickly and accurately identifies stroke patients at risk for aspiration due to acute-onset dysphagia. The Gugging Swallowing Screen (GUSS) involves a simple saliva swallowing test followed by sequentially performed tests of swallowing semisolid, liquid, and solid textures.
In the first sample of 20 patients who were evaluated within 2 hours of having a stroke, GUSS was 100% sensitive (proportion of patients whom the test correctly identified) and 50% specific (probability of those who don't have the condition being correctly identified) compared with fiberoptic endoscopy. In another sample that involved stroke specialty care nurses testing 30 stroke patients, GUSS was 100% sensitive and 69% specific. On average, liquids caused the greatest aspiration risk, leading researchers to recommend that patients receive liquids intravenously for the first 1 to 3 days following an acute stroke.
Researchers say their findings indicate that the GUSS assessment tool can quickly and reliably identify stroke patients with dysphagia and aspiration risk.
Trapl M, et al., Dysphagia bedside screening for acute-stroke patients, Stroke, November 2007.
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