Terapia de voz en el contexto de la pandemia covid-19; recomendaciones para la práctica clínica

Abstract

Introduction. Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. Objective. To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. Methods. A group of 11 experts in voice and swallowing disorders from 5 different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pandemic context. Results. The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. Conclusion. This guideline should be taken only as recommendations; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality.

Position statement of the Latin American Dysphagia Society for the management of oropharyngeal and esophageal dysphagia during the COVID-19 pandemic

“…However, the patient’s condition sometimes makes it impossible to defer the study. For example, COVID-19 patients, especially those that underwent endotracheal intubation after extubation in the intensive care unit (ICU), may need those procedures the most 37 , 38 .…”

“…Therefore, oropharyngeal manipulation represents a high risk of infection, by activating the cough or vomiting reflexes. In that context, the following specific recommendations are suggested 37 , 39 : Postpone follow-up endoscopic exams and screenings, if possible. Use the video recording system whenever possible, because adequate physical distance from the patient can be maintained and the study can be reviewed several times, to better understand the swallowing disorder.…”

Impacto del COVID-19 en la práctica clínica de la fonoaudiología en Colombia

“…En la actualidad, estos profesionales de la salud se ven enfrentados a un constante riesgo de contraer COVID-19 debido al contacto con la mucosa oral, secreciones pulmonares y aerosoles producto de conductas comunicativas y la activación de reflejos de protección de la vía respiratoria que tienen en su práctica laboral, independientemente de si el paciente se encuentra consciente y funcional para comunicarse o bajo sedación 12,16,17 . Estas situaciones retan a los fonoaudiólogos a implementar estrategias de evaluación y tratamiento que reduzcan el riesgo de contagio cuando han sido llamados a cumplir sus labores profesionales en función del mantenimiento de la salud y la disminución de complicaciones en el paciente [17][18][19] . O por el contrario, buscan cumplir con sus labores implementando medidas como la telesalud (también denominada telefonoaudiología) en escenarios de alto riesgo y en diversas alteraciones, necesitando formación profesional enfocada a esta metodología de intervención 20 .…”