Stroke Training and Awareness Resources (STARs)



Identifying signs of swallowing problems

When a person with a suspected stroke is admitted to hospital, it is a Scottish Stroke Care Standard for staff to carry out a swallow screening test within 4 hours of admission. This will determine whether the person is safe to eat and drink, or whether they require to remain nil by mouth until assessed by a Speech and Language Therapist.

Even after the initial swallow screening test,  it is important for all staff to recognise the signs of someone who might be having swallowing problems, and to know when to refer to a Speech and Language Therapist, and a Dietitian for specialist assessment and advice. Their advice will help you to know what consistency of food/drinks to give the patient, and the best and safest ways to support their nutrition and hydration intake.

  • coughing could be a sign of swallowing problems
  • choking is a sign of swallowing problems
  • vomiting is more often a sign of stomach or gullet problems
  • a moist gurgly voice could be a sign of swallowing problems
  • a change in breathing pattern could be a sign of swallowing problems
  • grinding teeth is not a sign of swallowing problems
  • a change of colour could be a sign of swallowing problems
  • pocketing/food residue is a sign of swallowing problems
  • drooling is a sign of swallowing problems

Page last reviewed: 16 Oct 2020