[2008] 1.6.3 People with suspected aspiration on specialist assessment, or who require tube feeding or dietary modification for 3 days, should be: re-assessed and considered for instrumental examination referred for dietary advice. [2008] 1.6.4 People with acute stroke who are unable to take adequate nutrition, fluids and medication orally should: receive tube feeding with a nasogastric tube within 24 hours of admission unless they have had thrombolysis be considered for a nasal bridle tube or gastrostomy if they are unable to tolerate a nasogastric tube be referred to an appropriately trained healthcare professional for detailed nutritional assessment, individualised advice and monitoring have their oral medication reviewed to amend either the formulation or the route of administration. [2008, amended 2019] Oral nutritional supplementation 1.6.5 Screen all hospital inpatients on admission for malnutrition and the risk of malnutrition. Repeat screening weekly for inpatients. [2008] 1.6.6 Screening should assess body mass index (BMI) and percentage unintentional weight loss. It should also consider the time over which a nutrient intake has been unintentionally reduced and/or the likelihood of future impaired nutrient intake. The Malnutrition Universal Screening Tool (MUST), for example, may be used to do this. [2008] 1.6.7 When screening for malnutrition and the risk of malnutrition, be aware that dysphagia, poor oral health and reduced ability to self-feed will affect nutrition in people with stroke. [2008] 2022 1.6.8 Screening for malnutrition and the risk of malnutrition should be carried out by healthcare professionals with appropriate skills and training. 1.6.9 Routine nutritional supplementation is not recommended for people with acute stroke who are adequately nourished on admission. [2008] 1.6.10 Start nutrition support for people with stroke who are at risk of malnutrition. This may include oral nutritional supplements, specialist dietary advice and/or tube feeding. 