The Ice Chip Protocol: A Description of the Protocol and Case Reports Purpose There is limited information regarding the theoretical underpinnings of an Ice Chip Protocol. This article aims to discuss its use in assessment and rehabilitation of swallowing disorders. Method A brief outline of the Ice Chip Protocol has been published, but in the present commentary, ... Article
Article  |   March 15, 2018
The Ice Chip Protocol: A Description of the Protocol and Case Reports
Author Affiliations & Notes
  • Jessica M. Pisegna
    Department of Otolaryngology, Boston Medical Center, Boston, MA
    Speech-Language Pathology Sciences, Boston University School of Medicine, Boston, MA
  • Susan E. Langmore
    Department of Otolaryngology-Head & Neck Surgery, Boston University Medical Center, Boston, MA
  • Disclosures
    Disclosures ×
  • Financial: Jessica M. Pisegna has no relevant financial interests to disclose. Susan E. Langmore has no relevant financial interests to disclose.
    Financial: Jessica M. Pisegna has no relevant financial interests to disclose. Susan E. Langmore has no relevant financial interests to disclose.×
  • Nonfinancial: Jessica M. Pisegna has no relevant nonfinancial interests to disclose. Susan E. Langmore has no relevant nonfinancial interests to disclose.
    Nonfinancial: Jessica M. Pisegna has no relevant nonfinancial interests to disclose. Susan E. Langmore has no relevant nonfinancial interests to disclose.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Part 1
Article   |   March 15, 2018
The Ice Chip Protocol: A Description of the Protocol and Case Reports
Perspectives of the ASHA Special Interest Groups, March 2018, Vol. 3, 28-46. doi:10.1044/persp3.SIG13.28
History: Received July 30, 2017 , Revised October 8, 2017 , Accepted November 15, 2017
Perspectives of the ASHA Special Interest Groups, March 2018, Vol. 3, 28-46. doi:10.1044/persp3.SIG13.28
History: Received July 30, 2017; Revised October 8, 2017; Accepted November 15, 2017

Purpose There is limited information regarding the theoretical underpinnings of an Ice Chip Protocol. This article aims to discuss its use in assessment and rehabilitation of swallowing disorders.

Method A brief outline of the Ice Chip Protocol has been published, but in the present commentary, we thoroughly describe the protocol. We explain the rationale, indications for use, steps, and expected outcomes. We also present 9 case reports of patients who presented as nil per os for a swallow evaluation and received the Ice Chip Protocol.

Result We demonstrate that the Ice Chip Protocol led to positive outcomes in the majority of the case reports. In 77.8% of the cases (7/9), secretion amount and location improved. Our anecdotal experiences suggest that it is a safe and successful protocol for both the evaluation and rehabilitation dysphagia. However, there is no systematic evidence for support.

Conclusion Clinicians and researchers are often asked to evaluate the swallows of patients who are severely dysphagic and sometimes critically ill. Our experience suggests that the Ice Chip Protocol is an effective and safe method, but it would greatly benefit from being formally studied. This commentary is meant to encourage more formal investigations of its outcomes.

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