Free Water Protocol for Swallowing Issues

Inclusion Criteria: * Stroke diagnosis or trauma patients being cared for by Trauma \& Acute Care Surgery (TACS) providers * Current orders for restricted or thickened liquids * Ability to control their own airway (i.e. airway adjuncts not needed) Exclusion Criteria: * Individuals who are medically fragile, as determined by treating physician, to include diagnosis of sepsis, need for vasopressors, or high oxygenation needs (requiring high-flow nasal cannula, Airvo, or oximask) * Individuals who refuse oral care, have any decayed teeth or dental disease, or have a documented active oral infection * Individuals with an advanced progressive neurological condition, active head/neck cancer, or those who are immunosuppressed * Individuals who are on bed-rest orders * Individuals who are lethargic or sedated * Individuals with suspected pre-hospital aspiration event and/or aspiration pneumonitis * Individuals with a fever of unknown origin * Individuals with a history of recurrent aspiration pneumonia/pneumonitis * Individuals whose primary language is one that the questionnaires are not available in a validated format