First Aid Phraseology: Dysphagia vs Dysphasia

Different Conditions with Nearly Identical Pronounciations

woman in hospital bed trying to speak
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There are two common problems that are treated by the same therapist and afflict the same type of patient, which sound virtually identical but are very different issues: dysphagia and dysphasia (pronounce them out loud and you'll see what I mean).

Both of these conditions are caused by neurological damage to the brain that comes from injury or a stroke. Both of these conditions are treated by speech therapists.

Both have to do with a person's ability to control muscles in the mouth and throat.

Dysphasia is difficulty speaking. It's one of the symptoms of a stroke that is easily recognized and should be a red flag if you're concerned about the possibility of a stroke or of brain damage. We say it a lot when reporting to the hospital on our patients in the back of an ambulance. Most paramedics will recognize dysphasia immediately and it becomes an important indicator of the patient's condition.

Dysphasia is often mistaken as being the same as confusion. It may seem that way when a patient is unable to say what she wants to. However, confusion is not understanding your environment or situation. Patients with dysphasia can't communicate verbally, but they often know exactly what's happening. Normally, they can hear perfectly and while they might not understand why they can't say what they want to say, these patients can usually understand what is said to them.

Dysphagia, on the other hand, is difficulty swallowing. It's also a symptom of a stroke, but it's not as commonly detected. There's virtually no reason a paramedic would have to test this in a patient. We don't give very many oral medications in the ambulance. The one common oral drug is aspirin, and we give that for heart attacks, not stroke.

Dysphagia is a huge problem in the hospital, however, because a patient needs to eat. I first learned the term because I didn't understand what a nurse was telling me—since the two terms sound exactly alike I thought she was saying the patient had a hard time speaking. It's true—as it commonly is—that the patient also had trouble speaking, but the nurse needed me to relay the correct condition to the nurses at the hospital where I was taking the patient. If they didn't realize the patient couldn't swallow, the patient could end up becoming even worse.

When a person who's had a stroke has trouble swallowing—dysphagia—there is a danger of aspirating or choking. Choking is having something block airflow in the trachea. Aspiration is inhaling food or fluid into the trachea. It doesn't completely block breathing like choking does, but aspiration can lead to pneumonia and even death.

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