Mouth care challenges and the use of the COVID-19 oral grading system: identifying risk factors for extubation in patients with COVID-19

Background The London Nightingale Hospital was set up in response to the COVID-19 pandemic to provide critical care for patients requiring intubation and ventilation. Its workforce comprised of redeployed medical, nursing and allied health clinicians, including Speech and Language Therapists (SLT), from a range of settings. Clinical Situation Speech and Language Therapists (SLTs) provide assessment and management of patients with speech, voice or swallowing difficulties post-extubation, with or without tracheostomy. In this setting of predominantly intubated patients, SLTs Discussion The COGS enabled systematic, structured assessment and monitoring of the oral cavity and upper airway of patients with COVID-19. Common deficits such as tongue swelling, and unmanaged oral secretions were identified as risk factors for complications peri and post-extubation. The systematic assessment tool was useful to measure outcomes of mouth care regimes and inform aspects of pre-extubation decision-making. It also provided a template for clinicians to increase their knowledge and understanding of this patient group to disseminate and share.