American Speech-Language-Hearing Association

Information For:

EBP Compendium: Summary of Clinical Practice Guideline

Canadian Stroke Network; Heart and Stroke Foundation of Canada
Canadian Best Practice Recommendations for Stroke Care: 2008
Canadian Stroke Network and the Heart and Stroke Foundation of Canada (2008).
Canadian Stroke Strategy, 114 pages.

AGREE Rating: Highly Recommended

Description:

This guideline provides recommendations regarding public awareness, prevention, management, and community reintegration following stroke. These guidelines are intended as a starting point for implementation of stroke strategies to improve care for provinces and territories of Canada. Evidence is graded A, B, or C. Grade A indicates a strong recommendation based on randomized controlled trials (RCTs) or meta-analyses of RCTs. Grade B evidence is based on a single RCT or strong evidence from a well-designed observational study. Grade C evidence is based on well-designed non-experimental, descriptive studies or expert opinion. 

Recommendations:

  • Assessment/Diagnosis
    • Assessment Areas
      • Swallowing
        • “Patients with stroke should have their swallowing ability screened using a simple, valid, reliable beside testing protocol as part of their initial assessment, and before initiating oral intake of medications, fluids, or food” (Grade B Evidence) (p. 179).
        • “Patients who are not alert within the first 24 hours should be monitored closely and dysphagia screening performed when clinically appropriate” (Grade C Evidence) (p. 179).
        • “Patients with stroke presenting with features indicating dysphagia or pulmonary aspiration should receive a full clinical assessment of their swallowing ability by a speech-language pathologist or appropriately trained specialist who should advise on safety of swallowing ability and consistency of diet and fluids” (Grade A Evidence) (p. 179).
    • Assessment Instruments
      • Swallowing
        • Bedside Swallow Exam - “Patients with stroke should have their swallowing ability screened using a simple, valid, reliable beside testing protocol as part of their initial assessment, and before initiating oral intake of medications, fluids, or food” (Grade B Evidence) (p. 179).

Keywords: Stroke

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Added to Compendium: October 2011

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