Electrolarynx iconFor awake, intubated patients a great frustration is the inability to speak. A great little report in NEJM shows a novel use of the electrolarynx – that little device some laryngectomised patients hold to their neck to produce robot sounding speech. But here, the authors used the electrolarynx on an awake, intubated patient.

Talking while intubated
According to the report, nurses were trained to apply the elctrolarynx in a couple of minutes, and the patient was immediately able to produce intelligeble speech. Well, the listeners might need to get accustomed to the monotone, robot-like sounds to understand the patient, but that should be a minor hurdle.

There’s a video clip in the NEJM link, showing the patient responding. It’s hard to make out what he’s saying, but it probably helps if you know Dutch. The report was made in a Dutch hospital, but shows that an electrolarynx might be handy to have around in the ICU for those on prolonged ventilator assist.

Communication and sanity
Many of these will get a trachie, and can then go on to either momentarily deflate the cuff to let air pass up through the vocal chords and let the patient speak, or with the help of a fenestrated tracheal cannula to let more air pass up through the vocal chords. But for some patients, that’s not an alternative, and an electrolarynx could help. Not just for communicating, but also keeping the patient sane and delirium at bay.

Speech in an Orally Intubated Patient, NEJM, 2014.

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