Brendan A McGrath1, Sarah Wallace. 1. aUniversity Hospital of South Manchester, Wythenshawe bDepartment of Speech Voice and Swallowing, University Hospital of South Manchester, Wythenshawe, UK.
Abstract
PURPOSE OF REVIEW: Tracheostomy care is evolving, with the majority of procedures now performed percutaneously to facilitate weaning from mechanical ventilation in the critically ill. Traditional surgical indications remain, but surgical tracheostomies are increasingly performed in more complex patients and procedures. This brings unique challenges for the multidisciplinary professional team in which speech and language therapists (SLTs) have a key role. RECENT FINDINGS: Reviews of tracheostomy-related critical incidents have identified recurrent themes associated with adverse outcomes for this high-risk population. Recent research has highlighted the impact of tracheostomy on communication and swallowing, along with the contribution of SLTs to the multidisciplinary professional team, prompting new guidance for SLTs. The UK National Tracheostomy Safety Project has developed educational and practical resources that have been shown to improve care. Similar approaches from around the world led to the newly formed Global Tracheostomy Collaborative. SUMMARY: Patients with tracheostomies can benefit from a co-ordinated, truly multidisciplinary approach to care. SLT-specific expertise in assessing and managing communication and swallowing needs is a vital part of this process.
PURPOSE OF REVIEW: Tracheostomy care is evolving, with the majority of procedures now performed percutaneously to facilitate weaning from mechanical ventilation in the critically ill. Traditional surgical indications remain, but surgical tracheostomies are increasingly performed in more complex patients and procedures. This brings unique challenges for the multidisciplinary professional team in which speech and language therapists (SLTs) have a key role. RECENT FINDINGS: Reviews of tracheostomy-related critical incidents have identified recurrent themes associated with adverse outcomes for this high-risk population. Recent research has highlighted the impact of tracheostomy on communication and swallowing, along with the contribution of SLTs to the multidisciplinary professional team, prompting new guidance for SLTs. The UK National Tracheostomy Safety Project has developed educational and practical resources that have been shown to improve care. Similar approaches from around the world led to the newly formed Global Tracheostomy Collaborative. SUMMARY:Patients with tracheostomies can benefit from a co-ordinated, truly multidisciplinary approach to care. SLT-specific expertise in assessing and managing communication and swallowing needs is a vital part of this process.
Authors: Brendan A McGrath; James Lynch; Barbarella Bonvento; Sarah Wallace; Val Poole; Ann Farrell; Cristina Diaz; Sadie Khwaja; David W Roberson Journal: BMJ Qual Improv Rep Date: 2017-05-23
Authors: Richard Birk; Alexander Händel; Angela Wenzel; Benedikt Kramer; Christoph Aderhold; Karl Hörmann; Boris A Stuck; J Ulrich Sommer Journal: Head Neck Date: 2017-10-09 Impact factor: 3.147