ATACP (2012) Aquatic Therapy for clients with a tracheostomy

Background and Aims of Aquatic Therapy for Tracheostomized Patients

Aquatic therapy, a recognized and effective treatment modality, poses unique challenges and risks when applied to clients with tracheostomies. The primary concern is the risk of water entering the airway, leading to aspiration. This evidence note aims to provide a comprehensive risk management tool to assist clinicians in evaluating the suitability of aquatic therapy for clients with tracheostomies, ensuring safety while leveraging the therapeutic benefits of water-based activities.

Methodological Approach to Developing Guidelines

The development of these guidelines involved a multifaceted approach, including a thorough literature review, a survey of expert clinicians, and extensive stakeholder consultation. The literature review aimed to gather existing evidence and recommendations regarding aquatic therapy for tracheostomized patients. The expert clinician survey, conducted via the InteractiveCSP internet forum, sought insights on current practices, protocols, and experiences in delivering aquatic therapy to this patient group. Stakeholder consultation further refined the risk management tool, incorporating feedback from a wide range of healthcare professionals and associations.

Key Findings and Recommendations

The literature review revealed a lack of randomized controlled trials specifically addressing the safety and efficacy of aquatic therapy for patients with tracheostomies. However, case studies and expert opinions underscored the potential benefits of aquatic therapy, provided that meticulous risk management is in place. The clinician survey highlighted the variability in current practices and the need for standardized protocols and equipment lists. Stakeholder feedback led to the refinement of the risk management tool, emphasizing the importance of individualized risk assessments, considering the client’s clinical features, staff expertise, and available equipment.

Implementing Aquatic Therapy: Considerations and Protocols

For successful implementation of aquatic therapy for tracheostomized clients, several key considerations must be addressed. These include assessing the client’s medical stability, ensuring the availability of specialized equipment, and planning for emergency scenarios. The staffing requirements for aquatic therapy sessions are particularly emphasized, recommending a minimum of two trained professionals in the water, with additional support poolside. The equipment list provided serves as a comprehensive checklist to prepare for each session, ensuring all necessary items are at hand to maintain the client’s airway and provide emergency care if needed.

Conclusion and Future Directions

Aquatic therapy offers significant rehabilitative potential for clients with tracheostomies, but its application requires careful planning, skilled personnel, and stringent safety measures. This evidence note presents a structured approach to risk assessment and management, enabling clinicians to make informed decisions about the suitability of aquatic therapy for individual clients. Further research is needed to establish evidence-based protocols and to standardize practice, enhancing the safety and efficacy of aquatic therapy for this unique patient population.