The Role of the SLP in Intensive Care

Management of Communication and Swallowing in Intensive Care: The Role of the Speech Pathologist 

The role of the SLP in acute care is multifaceted and requires a dynamic team approach. Baumgartner et al., (2008) look at both the management of swallowing and communication in the intensive care setting and outlines why SLPs are important members of the critical care team.

SLPs evaluate age-related swallow differences and swallow difficulties related to various etiologies. SLPs are called to assess a patient's risk for aspiration and make appropriate diet recommendations. In addition to swallowing, SLPs in critical care, assess and treat communication, cognitive, and voice differences.

Some individuals in intensive care units may require a tracheostomy. Managing tracheostomy patients relies heavily on SLPs, who assess the effects of tracheostomy, vent-dependent patients, and prolonged intubation on speech and swallowing (Baumgartner et al., 2008). SLPs determine whether a patient is eligible for, can tolerate, and successfully communicate using a speaking valve.

In addition to adult settings, SLPs have a role in the Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU). The patient population in the PICU can vary in age from day 1 or 2 after birth up to 18 years of age and represents a wide range of causes for hospitalization (Baumgartner et al., 2008). The NICU infant also presents many possibilities for intervention by the SLP, such as pre-feeding skills, state regulation, and coaching parents on safe feeding techniques. 

The role of the SLP in acute care is complex. The year 2020 specifically has, in many ways, highlighted the SLP role in the critical care of patients, specifically with regard to prolonged intubation and subsequent laryngeal edema. Additionally, the impact of coordination with respiration and its effect on swallowing. From bedside to radiology, Fiberoptic Endoscopic Evaluations of Swallow (FEES) assessments, Augmentative and Alternative Communication (AAC) consultations, alertness and cognition screenings, and team rounds; the SLP role is dynamic and crucial in the acute care setting.

Dysphagia Outreach Project aims to further educate individuals about swallowing disorders and provide assistance for individuals with swallowing disorders across the lifespan. Click ‘Apply for Assistance’ to fill out our application for supplies!

Baumgartner, C., Bewyer, E., Bruner, D. Management of communication and swallowing in intensive care: the role of the speech pathologist. AACN Advanced Critical Care, 19 (4) (2008), pp. 433-434

DOI: 10.1097/01.AACN.0000340724.80280.31