COVID-19 Pandemisi Sürecinde Dil ve Konuşma Terapisi Yönetimi: “Şimdi Ne Yapmalıyız?”

Year 2020, Volume: 3 Issue: 1, 1 - 30, 09.05.2020

Seyhun Topbaş , Namık Yücel Birol , Hilal Berber , Beril Polat Berna Kırımtay Ayşegül Yılmaz

Abstract

Tüm insanlık Aralık 2019’da Çin’in Wuhan kentinde ortaya çıkan ve tüm dünyaya yayılan COVID-19 pandemisi ile mücadele etmektedir. Bu virüs hasta bireylerden çoğunlukla damlacık yolu ile bulaşmakta olup ateş, öksürük, yorgunluk ve dispne gibi belirtilerle kendini göstermektedir. Hastalığın bulaştırıcılığının yüksek olması sebebiyle sıkı izolasyon ve hijyen önlemlerinin alınması gereklidir. COVID-19 pandemisi sırasında virüs bulaş riski ile en yoğun biçimde karşı karşıya olan grup, hastalıkla en ön safta mücadele eden sağlık çalışanlarıdır. Dil ve konuşma terapistleri de diğer sağlık çalışanları/profesyonelleri gibi pandemi sürecinde tüm dünyada ön saflarda hizmet vermekte olup hem hastayı hem kendisini koruması için aerosol üreten prosedürleri durdurması ve klinik uygulamaların türüne göre kişisel koruyucu ekipmanları kullanması gerekmektedir. COVID-19’un bazı kişilerde ağır seyretmesi nedeniyle hastalar yoğun bakımda tedavi görmektedir. Dil ve konuşma terapistleri yoğun bakımda da aktif çalışan sağlık uzmanıdır ve hastaların yoğun bakımda geçirdiği süreçte, hastaların yutma aspirasyon pnömonisi gibi değerlendirmelerin yürütülmesinin yanı sıra hasta ile sağlık personeli arasındaki iletişiminin sağlanması adına alternatif ve destekleyici iletişim sistemlerinin oluşturulmasında kritik rol oynarlar. COVID-19’a bağlı olarak bakıma ihtiyaç duyan hastaların birçoğunda akut solunum sıkıntısı sendromu gelişmekte ve hastalar uzun süreli mekanik ventilasyona ihtiyaç duymaktadır. Ventilasyon ihtiyacı ortadan kalkıp hastalar ekstübe edildikten sonra da ses ve yutma komplikasyonları açısından değerlendirilmeli ve gerektiğinde rehabilitasyon hizmeti sağlanmalıdır. Hastanede karşılaşılan yukarıdaki durumların yanı sıra, pandemi nedeniyle yüz yüze değerlendirme ve terapi yürütülmesinin mümkün olmadığı durumlarda teleterapi gibi uygulama adaptasyonlarına da ihtiyaç duyulmaktadır. Bu derleme ülkemizdeki dil ve konuşma terapistlerine COVID-19 pandemisi sırasında ve sonrasında birçok açıdan rehberlik etmeyi amaçlamaktadır. Yeni veri ve bilgiler edinildikçe güncellemeler yayınlanacaktır.

Keywords

COVID-19 coronavirüs pandemisi, dil ve konuşma terapisi, iletişim ve yutma bozukluğu, ekstübasyon sonrası disfaji, teleterapi, alternatif ve destekleyici iletişim sistemleri

Thanks

Makalenin gözden geçirilmesine katkıda bulunan Dr. Evra Günhan Şenol’a teşekkür ederiz.

Speech and Language Therapy Management during COVID-19 Pandemic: “What Should We Do Now?”

Abstract

All humanity is struggling with the COVID-19 pandemic, which appeared in Wuhan, China in December 2019 and spread all over the world. This virus is mainly transmitted through droplets produced by the infected individuals and the illness manifests with symptoms such as fever, cough, fatigue and dyspnea. Due to the highly contagious nature of the disease, strict isolation and hygiene measures must be taken. Healthcare professionals who are fighting against COVID-19 at the frontline face the highest level of virus transmission risk during this pandemic. Speech and language therapists, confronting the pandemic at the frontline along with their fellow healthcare providers as professionals, are forced to stop carrying out certain procedures that produce aerosols to protect both themselves and the patients, and use personal protective equipment when required by the clinical practice undertaken, as well as applying other modifications to service provision procedures. Because COVID-19 has a severe impact on some patients, they are admitted to intensive care units. When that is the case, the SLP’s play a critical role in ensuring the communication between the patients and the healthcare personnel. As an example, the use of alternative and augmentative communication systems can be sustained during intensive care. In addition, many patients in intensive care units develop acute respiratory distress syndrome. These patients need long-term mechanical ventilation. After the patients are extubated, they need to be evaluated for voice and swallowing disorders. In addition to the above-mentioned roles SLPs undertake at hospital settings, when it is not possible to carry out face to face evaluation and therapy, clinical adaptations and teletherapy may be recommended. This review aims to guide speech and language therapists in our country in many ways during the COVID-19 pandemic. Hence, the review will be surely updated, in the light of the new developments.

Keywords

COVID-19, speech and language therapy, communication and swallowing disorders, post-extubation dysphagia, telepractice, alternative and augmentative communication systems

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