In my experience, normally the healthcare professional who looks after them - often a nurse or HCA on a ward will identify a potential problem, then after discussion with a doctor will refer to speach and language therapists.
Some hospitals have a screening tool which nurses can use - trying thickened fluids or yoghurt first, before referral to speach and language.
In my experience, as a nurse, if you have any doubt, you discuss it with the patients doctor, then the patient is normally put nil-by-mouth until the SALT team assess them. Some sort of fluid would be given, either by intravenous line, or nasogastric tube until a person was assessed as safe to eat.
If there is any doubt, it is better that someone is Nil-by-mouth until a SALT assessment - the risk of aspiration pneumonia is too great otherwise.
During my nurse training, I was not taught how to effectively test someone's swallow - this is a specialist area, which must be done by those who are trained appropriately.
· 1 decade ago