Multidisciplinary Guidance for Safe Tracheostomy Care During the COVID-19 Pandemic: The NHS National Patient Safety Improvement Programme (NatPatSIP)
Anaesthesia
McGrath, B. A., Ashby, N., et al. (2020).
Anaesthesia, 75(12), 1659-1670.
This guideline from the U.K.'s National Health Service provides recommendations on safety practices to protect frontline clinicians, including speech-language pathologists, from exposure to COVID-19 during tracheostomy care. Recommendations should be considered with local conditions and institutional policies.
National Patient Safety Improvement Programme, National Health Service (United Kingdom)
<div>In individuals with tracheostomy, early involvement of speech-language pathologists using [augmentative and alternative communication] AAC will facilitate patient communication and participation and reduce anxiety.</div>
<div>For individuals with tracheostomy, the National Tracheostomy Safety Project recommends non-verbal communication aids, consultation with a speech-language pathologist, and review of the patient's communication plan once per shift.</div>
<p>When working with patients with tracheostomy during the COVID-19 pandemic, at minimum, the following personal protective equipment (PPE) should be used: gloves, aprons, eye protection and a fluid repellent surgical face mask for direct contact. For aerosol generating procedures, enhanced PPE including the additional use of a long-sleeved fluid-repellent gown/coveralls and an FFP3 or N95 respirator or [Powered Air Purifying Respirator] PAPR is required.<br><br></p>
<p>"Cuff deflation, ventilator-adjusted leak facilitated speech, one-way speaking valves, above-cuff vocalisation strategies and induced coughing risk aerosolisation, especially when positive-pressure ventilation is ongoing" ( p. 1667).</p>
<div>For individuals with tracheostomy, the National Tracheostomy Safety Project recommends a swallowing assessment and consultation with a speech-language pathologist.</div>
