By Jeremy Groves, Member of Council
One of my many deficiencies is an inability to lip read. Helplessness overcomes me as I try to understand patients with tracheostomies mouthing words, but I suspect my frustration is as nothing compared to theirs. I was thus intrigued to read in February’s JICS about a simple technique that could help in such situations.
Brendan McGrath and colleagues in their South Manchester ICU have been giving patients with tracheostomies a voice by using the subglotic suction port of their tracheostomy tubes to direct gas into the upper trachea. This enables their patients to phonate, albeit with what at times is no more than a whisper.
Their article in JICS describes the technique and presents five case reports of successful implementation. Modification of a medical device for a purpose for which it was not originally intended is not without risk. Humidification, the necessity for a patent upper airway and the risks of tube displacement are discussed.
It is often said that a picture is worth a thousand words. In patients emerging from critical illness, still beset by the weakness that critical illness imparts, the gift of speech may well be worth a thousand pictures.