University of Wisconsin-Madison.
Am J Speech Lang Pathol. 2021 Jan 27;30(1):63-74. doi: 10.1044/2020_AJSLP-20-00228. Epub 2020 Dec 17.
Purpose Evaluation and management of voice and upper airway disorders in adults and children, by speech-language pathologists worldwide, have been significantly altered by the COVID-19 pandemic. Secondary to the pathogenic nature of the virus in the respiratory tract and upper airway, it is essential that speech-language pathologists who specialize in these disorders are knowledgeable of current practices to provide evidence-based care while minimizing viral transmission. Understanding how and when SARS-CoV-2 spreads is critical to the development of effective infection prevention within clinical practices. Method We established an evidence-based clinical practice guide for clinicians working with voice and upper airway through a comprehensive evaluation of peer-reviewed journals, non-peer-reviewed manuscripts on preprint servers, national health guidelines, and published and online consensus statements and emerging data. Emphasis was placed on risk mitigation for viral transmission via safe clinical practices, including evaluative procedures, therapy including telehealth, personal protective equipment, room, staffing, and distancing considerations. Results/Conclusions While knowledge relevant to viral transmission of SARS-CoV-2 is rapidly evolving, there is a paucity of literature specific to the evaluation and treatment of voice and upper airway disorders. Within these confines and given the potentially significant high risk of infection secondary to the nature of COVID-19, we summarize current considerations and recommend best practices that maximize risk mitigation whereby ensuring patient and provider safety.
目的 由于 COVID-19 大流行,全球范围内的言语语言病理学家对成人和儿童的嗓音和上气道疾病的评估和管理发生了重大变化。由于该病毒在呼吸道和上气道中的致病特性,专门研究这些疾病的言语语言病理学家必须了解当前的实践,以便在最大程度地减少病毒传播的同时提供基于证据的护理。了解 SARS-CoV-2 的传播方式和时间对于在临床实践中制定有效的感染预防措施至关重要。
方法 我们通过对同行评议期刊、预印本服务器上的非同行评议手稿、国家卫生指南以及已发表和在线共识声明和新出现的数据进行全面评估,为从事嗓音和上气道工作的临床医生制定了基于证据的临床实践指南。重点是通过安全的临床实践减轻病毒传播的风险,包括评估程序、包括远程医疗在内的治疗、个人防护设备、房间、人员配备和距离考虑。
结果/结论 虽然与 SARS-CoV-2 病毒传播相关的知识正在迅速发展,但针对嗓音和上气道疾病的评估和治疗的文献却很少。在这些限制条件下,鉴于 COVID-19 的性质,感染的潜在风险很高,我们总结了当前的考虑因素,并建议了最佳实践,以最大程度地降低风险,从而确保患者和医务人员的安全。