Advice and Suggestions Requested

Hello everyone,

We have a request for input regarding the below situation. PLEASE POST YOUR FEEDBACK/OPINIONS/EXPERIENCES/RECOMMENDATIONS

The request for information comes from Caryn Langstaff, M.Sc., SLP(C), Regional Stroke Rehabilitation Coordinator,
Stroke Network of Southeastern Ontario

Perhaps Deb Willems can collect our responses and forward to Caryn.

Thank you for all your help!

“We are currently working with one of the community acute care hospitals on updating the clinical pathway and patient care order set for ischemic stroke. There have been some questions about the timing for P.E.G. placement. A brief review of the literature indicates controversy with early placement and some have expressed swallowing ability can change quickly or significantly in the early period.

The Rehab site presently does not accept patients requiring enteral feeds via NG tubes.
Given the need for early access to inpatient rehab (best practice target Day 5 for Ischemic Stroke), what is the thought about P.E.G. placement before transfer to inpatient rehab. This would mean P.E.G. placement by day 4 or perhaps day 5 before the transfer.

It would be challenging and controversial to have Percutaneous Endoscopic Gastronomy placement and transfer to rehab following a 5 day ischemic stroke clinical pathway.

Do you know of hospitals who achieve this timeline and if so how they are managing this?”



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