What is a neuroscience dietitian?
A neuroscience dietitian is responsible for seeing to the nutritional needs of patients who have had a brain injury or stroke.
When the supply of blood to the brain is cut off or reduced, a stroke can occur. Trauma or a spontaneous bleed can result in injury to the brain. A third of patients who have had a stroke, and a quarter-to-nearly-half of patients with traumatic brain injury, have a degree of swallowing difficulty. Following a swallow assessment by a speech and language therapist, the dietitian will advise on ensuring an adequate nutrition intake to maintain or improve the patient's nutritional status.
Some patients may not be able to swallow safely, and may need to be fed via a tube initially. The dietitian is responsible for prescribing the correct feed and monitoring the patient's progress on the feed. As a patient’s swallow improves, the dietitian will gradually reduce the volume of feed prescribed, and the patients will be encouraged to eat and drink more orally. It may be necessary to modify the texture of food and drinks to make it safer to swallow e.g. pureed food and/or thickened drinks. This is to prevent food getting into the windpipe and lungs (called aspiration), which can lead to chest infections and pneumonia.
Where appropriate, verbal and written information may be given to patients and/or carers during their stay in hospital or on discharge. We can also arrange for patients to receive nutritional supplements if required. Patients who are transferred to other units for rehabilitation and require follow up will be referred to the community dietitian. Information on reducing the risk of a further stroke can be arranged.
Who should I refer to a neurosciences dietitian ?
- Dysphagia who have been placed nil by mouth requiring enteral feeding
- Dysphagia who required texture modification
- Poor appetite or weight loss ("MUST" score >/= 2 for in-patients)
- Hyper/hyponatraemia requiring manipulation of fluid / sodium
British Brain and Spine Foundation: www.bbsf.org.uk
The Stroke Association: www.stroke.org.uk
Referrers may also find the following sites useful:
NICE Guidelines for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA)
British Dietetic Association: www.bda.uk.com