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Presence Learning Therapy Tools Suite - November 2019

Critical Illness Myopathy

George Barnes, MS, CCC-SLP

May 2, 2022



What is critical illness myopathy and what does it have to do with tracheostomy and ventilation?


Critical illness myopathy may occur in a medically complex patient who remains absent from functional activity for an extended period. This patient no longer has the resistance throughout the day needed to build their muscles. 62% of people who become ventilator-dependent begin to have some level of neuromuscular weakness (Shepherd et al., 2016). The reason the SLP needs to be aware of the high incidence of critical illness myopathy in the tracheostomy and ventilator dependent population is that the weakness is often widespread, substantial, and not limited to areas of the body that are below the neck. Lingual, labial, laryngeal, and pharyngeal function is often impacted by critical illness myopathy, causing significant issues with speaking and swallowing. This may lead to increased dependence and higher risks involved with introducing food and liquid; not only because of the high risk of aspiration but also because that aspiration may be more likely to result in a subsequent infection (Langmore et al., 1998 and 2002). 

To learn more about the care of patients with tracheostomy and/or mechanical ventilation and the role of the SLP, refer to SpeechPathology.com course, 20Q: Beyond the Swallow: Tracheostomy Tube and Ventilator Management

george barnes

George Barnes, MS, CCC-SLP

George Barnes MS CCC-SLP has developed an expertise in dysphagia with a focus on diagnostics in the medically complex population through his dedication to a variety of medical settings. George yearns to make education useful, research clinical-focused, and quality care accessible. His coaching program with FEESible Swallow Solutions supports SLPs with the guidance they need to reach their clinical and career goals. He co-founded a mobile FEES service to bring the highest quality assessment to the patient's bedside. His webinars bridge research and patient care. George strives to go beyond the swallow in dysphagia management by looking at the whole patient which is evident in his work on a pneumonia risk calculator. With a passion for food and a deep appreciation for the joy and connection it gives to our lives, he has dedicated his life to helping others enjoy this simple, but deep-rooted pleasure.

Related Courses

20Q: Beyond the Swallow - Tracheostomy Tube and Ventilator Management
Presented by George Barnes, MS, CCC-SLP


George Barnes, MS, CCC-SLP
Course: #10056Level: Intermediate1 Hour
  'Gave me confidence to work with trachs more'   Read Reviews
This course addresses the various questions that may arise for the medical SLP involved in the care of patients with tracheostomy and/or mechanical ventilation. Topics include causes of respiratory failure, consequences of tracheostomy/ventilation, risk management related to intervention, and considerations for assessment and treatment of swallowing and communication, including the use of speaking valves.

20Q: Velo-Cardio-Facial Syndrome (VCFS)
Presented by Karen J. Golding-Kushner, PhD, CCC-SLP, ASHA Fellow


Karen J. Golding-Kushner, PhD, CCC-SLP, ASHA Fellow
Course: #8700Level: Intermediate1 Hour
  'very detailed explanations and "real world" examples of how to teach these skills to parents/clients'   Read Reviews
This course describes the characteristics of Velo-cardio-facial syndrome that are of the greatest relevance to SLPs: those that affect feeding, speech and language. Best practice for intervention is also explained.

20Q: Pediatric Voice Disorders: Diagnostic and Treatment Approaches
Presented by Susan Baker Brehm, PhD, CCC-SLP, Barbara (Derickson) Weinrich, PhD, CCC-SLP, Lisa Nelson Kelchner, PhD, CCC-SLP, BCS-S


Susan Baker Brehm, PhD, CCC-SLPBarbara (Derickson) Weinrich, PhD, CCC-SLPLisa Nelson Kelchner, PhD, CCC-SLP, BCS-S
Course: #8972Level: Introductory1 Hour
  'Voice clients are infrequent in school settings'   Read Reviews
This course provides the practicing speech-language pathologist with information on special considerations in the treatment of children with voice disorders. The various causes of voice disorders are discussed as well as the treatment of specific types of disorders.

20Q: Evaluation and Treatment of Speech/Resonance Disorders and Velopharyngeal Dysfunction
Presented by Ann W. Kummer, PhD, CCC-SLP


Ann W. Kummer, PhD, CCC-SLP
Course: #8729Level: Intermediate1 Hour
  'This, combined with Dr'   Read Reviews
Children with speech and resonance disorders (hypernasality, hyponasality, and cul-de-sac resonance) and/or nasal emission present challenges for speech-language pathologists (SLPs) in all settings. This article will help participants to recognize resonance disorders and the characteristics of velopharyngeal dysfunction, and provide appropriate management.

Respiratory Muscle Strength Training and Speech-Language Pathologists: Part 1
Presented by Denise Dougherty, MA, SLP


Denise Dougherty, MA, SLP
Course: #9282Level: Intermediate1 Hour
  'This applies to almost every patient I work with'   Read Reviews
This is Part 1 of a two-part series. This course will provide an overview of respiration and why respiratory muscle strength training is important. Appropriate diagnoses for patient referral, including COVID-19, will be examined, as well as evidence for use of respiratory muscle strength training. (Part 2 - Course 9283)

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