Dr. Dolan’s story:  Persistence, multi-disciplinary team planning, and patient motivation all came together to get my patient home. They were initially admitted to a local hospital with COVID that quickly deteriorated requiring oral intubation for vent support. They ultimately transferred to a higher level of care due to progressive complications for placement on ECMO (a life-saving treatment that pumps oxygen into the bloodstream) for 64 days. Following those grueling two months, the patient transferred to my facility for continued efforts to wean ventilator support.

An interdisciplinary team approach was implemented to maximize early rehab mobility and efforts to decrease the amount of ventilator support needed. With weakened lungs, ventilator inline use of a PMV (Passy-Muir Valve) was started to be able to begin important breath work training with an EMST150 device. Mobility was also a key component to pulmonary improvements and the rehab team initiated ambulation on ventilator support through the hallways as quickly as possible. Diligence with completion of the EMST150 exercise protocols – first with SLP guidance for ventilator PMV placement, setting baseline pressure levels, and education on normative values for an attainable goal, the patient systematically advanced the pressure level toward that goal. I am convinced that the intervention provided using the EMST150 was the catalyst to their medical improvements.  Goals progressed to include swallowing assessments for initiation of an oral diet and eventually they were liberated from vent support with an additional successful tracheostomy decannulation – after an incredible five and half months from the first oral intubation date. The power of 5’s is real and my patient was able to go home!


About the Author

Dr. Kristin is a medical speech-language pathologist who has worked in long term care hospitals for the last 17 years providing both clinical patient services and administrative management as the rehab program director. She specializes in advanced intervention for adult long-term tracheostomized and ventilator-dependent patients including dysphagia management and in-line speaking valve use for early assessment and intervention of communication. Her passion for evidence-based interventions is the catalyst to providing hope, healing, and recovery toward improving patient outcomes.


Dr. Kristin Dolan; SLPD, CCC-SLP

Program Director

Kindred Hospital – Melbourne, Florida