22
Treatment
Î Use standardized stroke care order sets to improve general
management (I-B).
Î Assess swallowing before the patient begins eating, drinking, or
receiving oral medications (I-B).
Î Patients who cannot take solid food and liquids orally should receive
nasogastric, nasoduodenal, or percutaneous endoscopic gastrostomy
tube feedings to maintain hydration and nutrition while undergoing
efforts to restore swallowing (I-B).
Î Mobilize less severely affected patients early and take measures to
prevent subacute complications of stroke (I-C).
Î Treat concomitant medical diseases (I-C).
Î Institute early interventions to prevent recurrent stroke (I-C).
Î The use of aspirin is reasonable for treatment of patients who cannot
receive anticoagulants for prophylaxis of deep vein thrombosis (IIa-A).
Î In selecting between nasogastric and percutaneous endoscopic
gastrostomy tube routes of feeding in patients who cannot take solid
food or liquids orally, it is reasonable to prefer nasogastric tube
feeding until 2-3 weeks after stroke onset (IIa-B).
Î The use of intermittent external compression devices is reasonable for
treatment of patients who cannot receive anticoagulants (IIa-B).
Î Routine use of nutritional supplements has NOT been shown to be
beneficial (III-B).
Î Routine use of prophylactic antibiotics has NOT been shown to be
beneficial (III-B).
Î Routine placement of indwelling bladder catheters is NOT
recommended because of the associated risk of catheter-associated
urinary tract infections (III-C).
