A Conscious Approach to Decannulation: Clinical Application of a One-Way Speaking Valve With Disorders of Consciousness

Abstract

Purpose: This article compiles evidence to provide reasoning to advocate for early intervention with Disorders of Consciousness (DoC) by a speech-language pathologist to improve patient outcomes and reduce the cost of medical care in long-term management and rehabilitation. This article highlights the challenges of this patient population not demonstrating weaning and decannulation successes compared to other tracheostomized groups. DoC are significantly underserved diagnosis. This review highlights special considerations for optimizing and enhancing speech-language pathology early interventions to reduce the instance of misdiagnosis and to improve functional outcomes. Review of the literature resulted in a compilation of best practices. Conclusions: This article highlights evidence to support early intervention with DoC that can be directly applied to decannulation protocols for this patient population. The best practice in the care of patients with severe acquired brain injury should include speech-language pathology in the acute and rehabilitation phases. More research is needed in the profession to maximize skilled intervention and to improve prognosis in patients with DoC.