The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

Impact of Tracheostomy on Quality of Life

Mary Spremulli, MA, CCC-SLP, Sunday, December 7, 1997.

While Mike Harrell, RRT discusses the process of our multidisciplinary treatment team, I will focus on assessment issues, in particular, rationale for early placement of the Passy-Muir Speaking valve, not only for communication, but also for the restoration of other physiological functions. During the first 30 minutes of my presentation, I will review physiological functions affected by a tracheostomy. I will focus primarily on impact on swallowing function, since aspiration as a complication of feeding a patient prematurely can be a life-threatening problem, and also one which may delay or sabotage weaning attempts. On the foundation I present during the initial 30 minutes, I will conclude with discussing rationale for early placement of the Passy-Muir Valve, particularly with ventilator patients, towards improved communication, improved physiologic function, and improved quality of life. A flow chart or decision making tree, adapted from work by Dr. John Heffner, will be presented, with a description of how this may facilitate communication among health care team members, and provide for more systematic care of these patients. We have attempted to highlight current requirements from JCAHO, which include: focus on interdisciplinary management of patients; meeting the ethical needs of patients thru restoration of communication and participation in decision making; and the provision of quality care in a fiscally sound manner.

AARC 50th Anniversary, December 6 - 9, 1997, New Orleans, Louisiana.

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