Assessing Dysphagia in Burn Patients: Nurse’s Initial Steps for Care

In the realm of nursing, responding to the unique needs of each patient is paramount. When a burned client is admitted with signs of drooling and difficulty swallowing, it raises concerns about their ability to manage oral intake. The nurse’s initial actions are critical in ensuring the safety and well-being of the patient. In this article, we will explore the nurse’s best first action when faced with a burned client experiencing these symptoms and delve into the importance of dysphagia assessment in burn care.

Understanding Dysphagia in Burn Patients

Dysphagia refers to difficulty swallowing, a condition that can result from various underlying causes, including burn injuries. Burn injuries to the head, neck, or oropharyngeal area can lead to inflammation, edema, and scarring, which may affect the normal swallowing process.

The Nurse’s Vital Role

Nurses play a pivotal role in recognizing and addressing dysphagia in burn patients, as early intervention can prevent complications such as aspiration pneumonia, malnutrition, and dehydration. The nurse’s initial actions are crucial in identifying the severity of dysphagia and determining the appropriate interventions.

The Burned Client’s Symptoms: Drooling and Difficulty Swallowing

When a burned client on admission exhibits symptoms of drooling and difficulty swallowing, the nurse’s best first action should prioritize patient safety and accurate assessment. Here’s a step-by-step approach:

  1. Ensure Patient Safety: First and foremost, ensure the patient’s safety. If the client is actively drooling or experiencing severe difficulty swallowing, they are at risk of aspiration, which occurs when saliva or food enters the airway instead of the esophagus. Aspiration can lead to serious respiratory complications.
  2. Elevate the Head of the Bed: If the patient is in bed, elevate the head of the bed to a semi-Fowler’s or Fowler’s position. This positioning can help reduce the risk of aspiration by promoting the downward movement of saliva and secretions.
  3. Withhold Oral Intake: Temporarily withhold all oral intake, including food and fluids, until a comprehensive dysphagia assessment is conducted. This precautionary measure is essential to prevent further complications.
  4. Notify the Healthcare Team: Inform the healthcare team, including the physician, speech-language pathologist, and dietitian, about the client’s symptoms and the need for a dysphagia assessment.
  5. Initiate Dysphagia Assessment: The nurse, in collaboration with the speech-language pathologist, will perform a dysphagia assessment. This assessment typically includes evaluating the patient’s ability to swallow, assessing the risk of aspiration, and determining the appropriate diet consistency and fluid consistency (e.g., thickened liquids) based on the findings.
  6. Implement Recommendations: Once the dysphagia assessment is complete, the nurse will follow the recommendations made by the healthcare team. These recommendations may include modified diets, texture modifications, or specific swallowing exercises to improve the client’s swallowing function.
  7. Educate the Patient and Family: Provide education to the patient and their family about dysphagia management, including dietary restrictions, positioning during meals, and the importance of adhering to the recommended plan of care.


In the care of burn patients, recognizing and addressing dysphagia is vital for preventing complications and ensuring optimal recovery. When a burned client exhibits symptoms such as drooling and difficulty swallowing on admission, the nurse’s best first action is to prioritize safety, initiate a dysphagia assessment, and collaborate with the healthcare team to develop an individualized plan of care. Through early intervention and a comprehensive approach to dysphagia management, nurses can contribute significantly to the well-being and successful recovery of burn patients with swallowing difficulties.


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