title: Facilitating speech in the patient with a tracheostomy.
abstract: A tracheostomy tube decreases the ability of the patient to communicate effectively. The ability to speak provides an important improvement in the quality of life for a patient with a tracheostomy. In mechanically ventilated patients, speech can be provided by the use of a talking tracheostomy tube, using a cuff-down technique with a speaking valve, and using a cuff-down technique without a speaking valve. Speech can be facilitated in patients with a tracheostomy tube who are breathing spontaneously by use of a talking tracheostomy tube, by using a cuff-down technique with finger occlusion of the proximal tracheostomy tube, and with the use of a cuff-down technique with a speaking valve. Teamwork between the patient and the patient care team (respiratory therapist, speech-language pathologist, nurse, and physician) can result in effective restoration of speech in many patients with a long-term tracheostomy.
authors.affiliation: Department of Respiratory Care, Ellison 401, Massachusetts General Hospital, 55 Fruit Street, Boston MA 02114, USA. dhess@partners.org
authors.forename: Dean R
authors.initials: DR
authors.lastname: Hess
mesh_terms: D004867:Equipment Design; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D011788:Quality of Life; D012121:Respiration, Artificial / Q000295:instrumentation; D012656:Self-Help Devices; D013070:Speech Therapy / Q000379:methods*; D014139:Tracheostomy / Q000295:instrumentation / Q000534:rehabilitation*