Role of the speech therapist in the evaluation of swallowing after ischemic stroke in the intensive care unit

Abstract

The speech therapist is able to integrate interdisciplinary intensive care teams with the aim of detecting swallowing disorders in post ischemic stroke patients, due to his academic training and the National Law No. 27.568 that supports their competences. The aim of the present work was to analyze the phonoaudiological practice of speech therapists working in intensive care units (ICU), with respect to the evaluation of swallowing in post ischemic stroke patients in the city of Córdoba, during March and April of 2024.

Research with a qualitative approach and phenomenological method. The project was approved by the Institutional Health Research Ethics Committee, which made it possible to begin data collection by means of ad hoc, semi-open, self-administered questionnaires. The population was recruited by means of a call and consisted of speech therapists working in the ICU of the city of Córdoba who provide care to post-ischemic stroke patients. The sample selection method was non-probabilistic, through the convenience criterion, and consisted of 13 subjects. The following methods of analysis were used: qualitative, trend analysis, grounded theory and content analysis.

The results show that most of the speech therapists interviewed are within the ICU team and are part of a multi-professional speech therapy service; even so, they described the lack of interdisciplinary work. All agreed on the importance of incorporating speech therapists in all the country's ICUs, and on the importance of early evaluation of swallowing after ischemic stroke by a trained professional. Preference was shown for the Gugging Swallowing Screen, Volume-Viscosity Swallowing Test and Clinical Observation methods for the detection of dysphagia, which are modified according to the patient's condition. 

It is concluded that the phonoaudiological role is responsible for activities such as the evaluation of swallowing after ischemic stroke in the ICU, but this does not guarantee that it is the first professional to address the function. The lack of consensus for the detection of dysphagia is evidenced due to the great variability of the methods mentioned.