SLPs operate within various healthcare settings—acute care, inpatient, and outpatient rehabilitation—to identify and manage these deficits. Here are key takeaways from the research and practical strategies for SLPs:
Acute and Intensive Care Units
- Dysphagia Screening and Assessment: Post-extubation dysphagia screening is crucial for COVID-19 patients due to the high incidence of swallowing difficulties. Clinical bedside screenings should be conducted to assess the patient's medical history, oropharynx structure, and trial swallows of food and liquids.
Inpatient Rehabilitation Units
- Dietary Modification: Collaborate with dietitians and other healthcare professionals to ensure safe oral feeding and minimize the risk of aspiration.
- Compensatory Training: Implement strategies like postural changes and swallowing maneuvers to support safe food and liquid intake.
- Swallowing Exercises: Recommend exercises such as effortful swallowing and the Mendelsohn maneuver to improve the strength and range of motion of the pharyngeal and laryngeal structures.
- Tracheostomy Management: Evaluate swallowing before initiating an oral diet and consider the use of a speaking valve to reduce aspiration risks.
- Oral Care and Hygiene: Educate patients on consistent oral care to prevent bacterial colonization and reduce the risk of aspiration pneumonia.
- Delirium Screening: Use delirium checklists to identify symptoms and engage patients in cognitively stimulating activities to reduce the risk of delirium.
Outpatient Rehabilitation Units
- Speech Intelligibility Enhancement: Train patients with tracheostomies to speak using a one-way speaking valve to improve speech intelligibility.
- Voice Rehabilitation: Address post-intubation dysphonia by assessing vocal parameters and providing strategies to improve voice quality.
- Neurocognitive Management: Conduct cognitive screenings and provide training exercises to address neurocognitive deficits.
Current Precautionary Measures
SLPs must follow strict infection control precautions to reduce virus transmission. These include using personal protective equipment, adhering to droplet and airborne precautions, and considering tele-practice as an alternative to in-person care.
SLPs play a vital role in the comprehensive care of COVID-19 patients, from early screening and individualized treatment plans to patient education and family training. Their contributions are essential for the social reintegration and improved quality of life for patients recovering from COVID-19.
To read the original research paper, please follow this link: Speech-Language Pathologists Role in the Multi-Disciplinary Management and Rehabilitation of Patients with Covid-19.
