Background: Intubated patients experience an intensified need to communicate while their ability to do so is compromised as the endotracheal tube prevents speech which creates patient agitation.Aim: To determine the impact of using augmented alternative communication methods on outcome of intubated COPD patients.Patients and methods: Sixty male COPD intubated patients at the pulmonary critical care unit Mansoura University hospital were randomly assigned into two groups of 30 patients for each. The control group involved patients receiving the routine nursing communication practices while the study group involved patients who utilized modified communication board and paper/pen as an augmented alternative communication methods. Unconscious patients, visual and/or hearing impairment were excluded. Patient satisfaction questionnaire (PSQ), Patient Communication level, duration of intubation and mortality were adopted as endpoints.Results: Based on PSQ, 10% in the study group were very dissatisfied compared to 53.33% in the control group the difference was statistically significant. On the other hand, 40% in the study group were very satisfied compared to 6.66% in the control which was a statistically significant increase p < 0.001. However, the mortality did not differ significantly in both groups 16.66% in the control group compared to 13.33% in the study group.Conclusion: Alternative communication methods can improve the level of satisfaction and decrease distress but it did not change mortality in intubated COPD patients.