6. Hands-free speech
Introduction
Provox FreeHands HME automatic speaking valve
Attachment of the valve
Peristomal attachment
Intratracheal fixation
Assembling and disassembling the HME
Choosing the membrane
Proper adjustment of the cough-relief valve
Using the walk and talk position
Use of the cleaning container
Speech therapy. What to practice to optimize hands-free speech
Closure of the membrane
Breath-support/breath-voice coordination
Phrase length, speech rate, maximum phonation time
Pitch, loudness, intonation
Shouting
Decrease backpressure
Hypertonicity/spasm of the neoglottis
Hypotonicity of the neoglottis
Confusing hands-free TE-speech with esophageal speech
Conclusion
Troubleshooting
No voice sound
Weak/whisper/aphonic voice
Air leakage under membrane
Air escaping underneath cough-relief valve
Shortness of breath
Cough-relief valve opens when patient is speaking loud
Seal of the adhesive does not last long
Problems with intratracheal fixation
Too much noise of cough-relief valve when coughing
Reference s
