رجل عمره ٧٤ سنة دخل قبل ٦ ساعات بسكتة دماغية في الجهة اليسرى، عنده ضعف في الوجه الأيمن وصوته متغير. التشبع ٩٦٪، والوعي جيد، وهو جائع ويطلب الأكل. قبل أول وجبة، خلال فحص البلع على السرير، أي علامة تدل على أعلى خطر شفط؟

A 74-year-old man admitted 6 hours ago with a left hemispheric stroke has right facial weakness and a changed voice. SpO2 96%, alert, hungry and asking for food. During the bedside swallow screen before his first meal, which sign indicates the highest aspiration risk?

1. A wet, gurgly voice after a sip of water
2. A normal and equal shoulder shrug
3. The tongue in the midline when protruded
4. Being able to whistle clearly

Answer: A) A wet, gurgly voice after a sip of water. A wet voice after swallowing means fluid reached the larynx (CN IX/X weakness). Stop oral intake and refer to speech-language pathology.