The Barnes Jewish Hospital Stroke Dysphagia Screen is a systematic evaluation designed and implemented to assess the risk of aspiration in stroke patients, with a focus on those potentially exhibiting dysphagia. The process involves two primary components: screening questions addressing neurological and physical symptoms, and a practical water swallow test.

Initially, patients are assessed through a series of yes/no screening questions:

- Is the Glasgow Coma Scale score below 13?
- Is there any facial asymmetry or weakness present?
- Is there any tongue asymmetry or weakness present?
- Is there any palatal asymmetry or weakness present?

Based on the responses:

- If none of the symptoms (all "No" for questions) are present, it's recommended to refer the patient to speech pathology without proceeding to the water test.
- If any of these symptoms (any "Yes" response) are observed, the next step is to conduct a 3-ounce water swallow test.

In the water swallow test:

- If the patient shows no signs of aspiration during the test, the result indicates a "Swallow screen passed," suggesting a low risk of aspiration and allowing for a regular diet.
- If there are signs of aspiration, it implies a "Failure of the water swallow screen," and the patient should be referred to speech pathology for further assessment before dietary adjustments.

This process ensures that each step of the evaluation is thorough and informative, prioritizing patient safety by identifying those who may need speech pathology intervention. By distinguishing between those who are immediately eligible for a regular diet and those requiring further examination, this screening protocol supports optimal care management in post-stroke recovery.

The Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) is a clinical tool designed for the assessment of dysphagia risk after stroke. This calculator helps to identify patients who are at a higher risk of developing aspiration pneumonia, facilitating early intervention and potentially reducing morbidity and mortality. The BJH-SDS evaluates factors such as consciousness level, ability to follow commands, and presence of a voice change after swallowing water. It is important to note that this tool is not applicable to patients who are unconscious or unable to follow commands, as their ability to participate in the screening process is compromised. Furthermore, the BJH-SDS should not be used as a standalone diagnostic tool for dysphagia but should be incorporated into a comprehensive clinical evaluation.