A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19.
Amy Freeman-Sanderson, Elizabeth C Ward, Anna Miles and 8 others
PMID 33166525WHAT IT FOUND
Thirty-five ICU speech-language pathologists agreed on 64 of 66 statements for managing communication and swallowing.
They did not agree that speaking is a low-risk aerosol-generating procedure, or that gag-reflex testing is an aerosol-generating procedure. These are expert recommendations, not tested interventions.
Key findings
01Experts reached consensus on 64 of 66 statements about ICU communication and swallowing management.
02The statement that speaking is a low-risk aerosol-generating procedure did not reach consensus.
03Participants agreed that a voluntary cough is an aerosol-generating procedure, but gag-reflex testing did not reach consensus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study asked experts to agree with statements. It did not test whether the statements improve patient outcomes. 66% of participants came from Australia, the United Kingdom, and the United States, even though 12 countries were represented. The questionnaire was distributed on May 11, 2020, and a later questionnaire was distributed on June 17, 2020. Knowledge about SARS-CoV-2 and aerosol procedures was changing during that period. Experts were recruited through investigators' networks and peer recognition, so they may not represent all ICU clinicians. Two statements about aerosol-generating procedures did not reach consensus, so those points are not settled.
Declared interests
The supplied text marks the work as supported by non-U.S. government research. No author conflict-of-interest declaration is included.
The easy way to misread this
Do not read the 97% consensus as proof that these ICU practices improve patient outcomes. The study recorded expert agreement, not tested interventions, and two aerosol-generating procedure statements did not reach consensus.