ICU communication board: free large-print printable

Who it’s for

Patients in an intensive care or high-dependency unit who are awake but can’t speak, for example with a breathing tube or a tracheostomy, and the family members and staff at the bedside. It’s different from our hospital communication board: that one has more words and a letter page, for patients who can manage a busier board. This one has far fewer, far bigger choices, for patients who are very weak, drowsy or can only point roughly.

How to use it at the bedside

1. Ask the nurse first. Check it’s a good moment, and whether the patient can see without glasses.
2. Hold the board close and still, where the patient can see it and reach it, or look at it.
3. Start with yes and no. “Can you show me yes?” Then ask one question at a time and wait.
4. Read back what they chose. “You pointed to mouth dry. I’ll tell the nurse.” Don’t give food or drink without asking the nurse.
5. Keep it short. A few questions, then let the patient rest. Come back later.

Where it hurts, and how much

Ask first: “Are you in pain?” If yes, the patient points to the body outline on page 2, or you point and they say yes. Then move your finger slowly along the 0 to 10 scale and let them stop you. Tell the nurse in the patient’s words: “He pointed to his chest, and to 6.” The nurse decides what happens next.

For family at the bedside

Being with someone who can’t talk is hard for the visitor too. The board gives you something to do: ask whether they are comfortable, too hot or too cold, and whether they want the lights off. The questions on page 2 are ones that are hard to ask without a voice, like What happened? and Is my family coming? If you don’t know the answer, say so, and ask the nurse together.

What’s on the board

Page 1

• yes
• no
• I don’t know
• nurse
• suction
• can’t breathe
• mouth dry
• in pain
• too hot
• too cold
• toilet
• turn me
• my family

Page 2

• body outline
• pain 0 to 10
• pillow
• blanket
• glasses
• lights off
• quiet, please
• sit me up
• What happened?
• Where am I?
• What day is it?
• Is my family coming?
• Am I getting better?
• When can the tube come out?

Printing and cleaning

• Print each page on its own sheet, sideways, and put it in a sheet protector or laminate it, so it can be wiped. Follow the unit’s cleaning rules.
• Ask the nurse before bringing anything into the unit; some units have their own boards or rules.
• When the patient is ready for more words, move on to the hospital communication board, which has a letter page for spelling.
• Ask whether a speech-language pathologist can see the patient. They can help find the best way to communicate.

For the time after intensive care, read AAC for adults: after a stroke, with ALS or MND, and in the hospital. Nurses and care staff: how to communicate with nonverbal patients covers yes and no signals, questions a patient can answer, and handover between shifts.