RESUMO
Early speaking valve application in children with tracheostomies is encouraged for language development. Whether an institutional multidisciplinary protocol impacts the patient population and timelines for which a speaking valve is trialed has not been studied. This retrospective study compared speaking valve trials performed at a pediatric quaternary hospital over a 12-year period. Timelines (time between tracheostomy insertion, speech-language pathologist (SLP) consultation, speaking valve order, and trial) and patient characteristics (demographics, tracheostomy classification, and feeding status) were collected. Medians (IQRs) compared timelines before and after a protocol was instituted and compared the timelines between tracheostomy classifications. Median time between tracheostomy insertion and SLP consultation did not change: before protocol-1.8 (7.7) months and after protocol-1.8 (2.4) months. Time between tracheostomy insertion and speaking valve trial decreased: before protocol-34.1 (40.5) months and after protocol-12.9 (8.4) months. Time between tracheostomy insertion and trial was not different between tracheostomy classifications: upper airway obstruction-16.0 (27.1) months, complex medical condition-36.3 (45.8) months, and invasive ventilation-17.5 (22.3) months. An institutional multidisciplinary protocol decreases the time between tracheostomy insertion and speaking valve trial, regardless of the reason the tracheostomy is needed in the pediatric population.
