ATACP (2012) Aquatic Therapy for clients with a tracheostomy

The clinical effectiveness of aquatic therapy is established (1). This is a recognised treatment for people with tracheostomies providing staff have been adequately trained and thorough risk assessments are completed. The risks of taking anyone into a pool are already covered by the Chartered Society of Physiotherapy’s 2006 Guidance on Good Practice in Hydrotherapy (2). The obvious risk when taking someone with a tracheostomy into a pool is that water will enter the airway,
leading to aspiration. This guidance was therefore compiled to assist the clinical reasoning and risk assessment process preceding an individual with a tracheostomy commencing water-based activity.

Key points:
1 There is good evidence for the use of aquatic therapy.
2 clinicians highlight the need for careful risk management when using aquatic therapy forclients with tracheostomies.
3 This document describes the process used to synthesise the limited evidence base with expert clinical opinion in order to identify key risk assessment considerations to ensure that clients with tracheostomies, who might benefit from aquatic therapy, are appropriately managed.
4 clear recommendations to help risk assessment decision making are provided in relation to individual client clinical features, staff experience and numbers, and the availability of necessary equipment.

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