Safer use of speech valves for preventing aspiration on saliva in institutions:

DOI
  • Matsubayashi Yoshiko
    Tokyo Metropolitan Tobu Medical Center for Persons with Developmental/ Multiple Disabilities, Koto, Tokyo
  • Ide Shuhei
    Tokyo Metropolitan Tobu Medical Center for Persons with Developmental/ Multiple Disabilities, Koto, Tokyo
  • Kishino Ayako
    Tokyo Metropolitan Tobu Medical Center for Persons with Developmental/ Multiple Disabilities, Koto, Tokyo

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Other Title
  • 施設内で唾液誤嚥防止目的のスピーチバルブをより安全に使用するために
  • Case study showing methods and results in an institution.
  • −症例を通しての施設内での導入方法と効果−

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Description

It has been reported that the placement of a speech valve (SV) can reduce the inflow of saliva in the trachea of patient with a simple tracheotomy who require frequent intratracheal suctioning of saliva in the trachea. We placed an SV on one such patient residing at our institution, with the following results. (1) A rise in percutaneous arterial oxygen saturationwas achieved and maintained stably. (2) Daily urinary output increased. This may be a result of a decrease in the inflow of saliva into the trachea and/or of intratracheal suctioning volume. (3) In a survey of family members and ward staff, many felt that there was less tension and more smiling and that being able to hear vocalizations promoted communication, indicating an increase in thepatient's quality of life (QOL).Nevertheless, the SV was not able to stop the flow of saliva into the trachea completely, suggesting that sufficient phlegm expulsion and respiration monitoring are still required even with the SV. While it may be dangerous to use an SV with insufficient understanding of the mechanisms for patients with a tracheal cannula without a side hole, ward staff training and dialogue may enable safe use of SVs in institutions and help raise the residents' QOL.

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