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Early Enteral Feeding Post-Stroke — FRCA Final MCQ

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ModerateIntensive Care MedicineEarly Enteral Feeding Post-StrokeFRCA Final

A 72-year-old man in ICU following a stroke has impaired consciousness (GCS 9) and is at risk of aspiration. He has been nil by mouth for 5 days. According to NICE NG204 and current evidence, when should enteral feeding via nasogastric tube be commenced after acute stroke?

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Correct answer: C — Only via PEG tube – NG feeding is contraindicated in stroke

NICE NG204 (2022) and the FOOD trial evidence recommend that enteral feeding via nasogastric tube should be commenced within 24 hours of admission for patients with dysphagia/unsafe swallow following acute stroke. Early enteral nutrition is associated with improved outcomes compared to delayed feeding. PEG (percutaneous endoscopic gastrostomy) should only be considered if NG feeding is needed for >4 weeks. Formal swallowing assessment by speech and language therapy should be performed within 4 hours of admission. Aspiration risk should be managed with positioning, NG tube placement confirmation, and rate-controlled feeding.

Reference: NICE – 2022 – NG204 Stroke and TIA; Dennis MS et al – 2005 – FOOD trial