The Very 10 Reasons Why You Need an NDIS Nursing Assessment for Medically Complex Disabilities
The Very 10 Reasons Why You Need an NDIS Nursing Assessment for Medically Complex Disabilities
https://intensivecareathome.com/intensive-care-at-home-now-in-the-u-s/
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30 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $3,299
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14 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $1,999
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7 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $1,299
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4 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $999
https://intensivecarehotline.thrivecart.com/four-days-11-phone-consulting-us/
2 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $499
https://intensivecarehotline.thrivecart.com/two-days-11-phone-consulting-us/
You don’t have to use the 2, 4, 7, or 14 days in a row and you can use the days at your own pace.
Here's the hour option
Book 60 minutes 1:1 phone consulting and advocacy for $249 (can be credited towards any of the options above)- click on the link
https://intensivecarehotline.thrivecart.com/one-hour-11-phone-consulting-us/
Or you can join the membership here where you have access to me in the membership area for only US $199/ month where I advise daily and where you also have access to more material including all of our eBooks! Furthermore, you’ll get a 20% discount for 1:1 phone consulting and advocacy if you are a member!
https://intensivecarehotline.thrivecart.com/membership-us/
Here is also a link to case studies
https://intensivecarehotline.com/category/questions/
https://intensivecareathome.com/category/case-studies/
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1
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Long-Term Ventilation and/or Tracheostomy at Home! How to Improve Insufficient Support at Home!
Long-Term Ventilation and/or Tracheostomy at Home! How to Improve Insufficient Support at Home!
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Why Critical Care Nurses are Needed 24/7 for Long Term Ventilation & Tracheostomy in the Community!
Why Critical Care Nurses are Needed 24/7 for Long Term Ventilation & Tracheostomy in the Community!
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Why Legislation is Needed to Get More Patients Home, Out of ICU and Out of Hospital!
Why Legislation is Needed to Get More Patients Home, Out of ICU and Out of Hospital!
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3
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Why a Specialist NDIS Support Coordinator is Required When it Comes to Ventilation & or Tracheostomy
Why a Specialist NDIS Support Coordinator is Required When it Comes to Ventilation & or Tracheostomy
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Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
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Can INTENSIVE CARE AT HOME Take My Mother Home with Tracheostomy and Dialysis?
https://intensivecareathome.com/can-intensive-care-at-home-take-my-mother-home-with-tracheostomy-and-dialysis/
Can INTENSIVE CARE AT HOME Take My Mother Home with Tracheostomy and Dialysis?
Book your free 15-minute phone consultation here
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And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies. We also provide care to otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure) ventilation, home tracheostomy care when adults and children are not ventilated. Also, Home TPN (total parenteral nutrition), Home IV potassium infusions, Home IV magnesium infusions, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care at home that also includes ventilation weaning.
We have also provided an emergency department bypass service in the past for the Western Sydney Local Area Health District, which successfully kept patients at home as opposed to them going to an emergency department as part of a successful tender.
Now, in today’s video, I have a question from Desiree, who says,
“Hi Patrik,
My mother has a tracheostomy but is not on a ventilator. I’m having difficulties finding a provider that can take my mother home from the hospital. She also needs dialysis treatment while she’s at home or in an outpatient center. So, I’ve now begun looking into several providers, but I’m still hit with roadblocks. Nobody seems to want to take my mother home with a tracheostomy needing dialysis. It’s currently up in the air as to whether someone can take her home or not. Is this something Intensive Care at Home can help with?”
Well, thanks, Desiree, for sending your question through here.
Now, this is something that we can absolutely help with. This is bread and butter for us. With going to dialysis as an outpatient, that’s certainly a possibility. Once your mom is at home with a tracheostomy, she needs 24-hour intensive care nurses at home because a tracheostomy is an artificial airway that requires the skill of intensive care nurses, 24 hours a day, to keep your mom out of hospital predictably.
Few weeks ago, I’ve done a YouTube live with the title, “A blueprint for hospital discharge with tracheostomy with Intensive Care at Home.” I talked about an evidence-based discharge.
So, what do I mean by that? Evidence-based means that home care for tracheostomy patients is evidence-based, and you can look up the evidence on our website intensivecareathome.com under the Mechanical Home Ventilation Guidelines. So, these guidelines are a result of over 25 years Intensive Care at Home nursing in Germany where it all started, and over 10 years of Intensive Care at Home nursing in Australia.
Now, with Intensive Care at Home and clearly the Mechanical Home Ventilation Guidelines once again are evidence-based and say that only critical care nurses with a minimum of two years critical care nursing experience can keep patients at home safely on ventilation and/or tracheostomy.
So, in order to get your mom home safely, I’m not surprised that you are hitting roadblocks because, there might be some providers out there who can say they can do that with support workers or with general registered nurses. Unfortunately, I have to give you bad news.
Continue reading at: https://intensivecareathome.com/can-intensive-care-at-home-take-my-mother-home-with-tracheostomy-and-dialysis/
16
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INTERVIEW WITH INTENSIVE CARE AT HOME SPECIALIST NDIS SUPPORT COORDINATOR, AMANDA RICHES
INTERVIEW WITH INTENSIVE CARE AT HOME SPECIALIST NDIS SUPPORT COORDINATOR, AMANDA RICHES
Book your free 15-minute phone consultation here
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https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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My Daughter's on a Ventilator&Tracheostomy&Dialysis, ICU Says She Can't Be Weaned, Can She Go Home?
https://intensivecareathome.com/my-daughters-on-a-ventilator-tracheostomy-dialysis-icu-says-she-cant-be-weaned-can-she-go-home/
My Daughter's on a Ventilator & Tracheostomy & Dialysis, ICU Says She Can't Be Weaned, Can She Go Home?
Book your free 15-minute phone consultation here
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Call directly 24/7
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Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children with tracheostomies, also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), also home tracheostomy care when adults and children are not ventilated. We also provide Home TPN (total parenteral nutrition). We provide IV potassium, IV magnesium infusions at home as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home, and that also includes ventilation weaning at home.
We have also provided an emergency department (ED) bypass service for the Western Sydney Local Area Health District as part of a tender in the past, and we have sent critical care nurses into the home to avoid emergency department presentations and keep emergency departments empty as well.
Today, I want to answer a question from Eva who says,
“Hi Patrik,
My daughter is on a ventilator with a tracheostomy, and the doctors are saying she can’t be weaned off the ventilator. She’s also on dialysis. They are suggesting to withdraw life support and let her die and turn off the ventilator. My daughter wants to live. Can we take her home?”
Of course, you can take her home. It’s quite clear that you can go home. You can just have a look at our case studies. We’ve been providing hundreds of thousands, if not millions of hours of Intensive Care at Home nursing now for similar clients in the community that were on the brink of dying in intensive care and they went home to improve their quality of life and in some instances, quality of end of life. Of course, I need to know more about your daughter’s situation. I need to know and understand all the ins and outs. However, let’s just say she is end of life, again, I don’t know the all the ins and outs. She can improve her quality of end of life at home and can have palliative care at home but that might not even be the case.
Many of our clients have been in intensive care sometimes for years, in and out, or for years, months on end and intensive care units often wanted to withdraw treatment and then either the ICUs or the family found out about our service and then we have taken patients home and they have lived at home for long periods of times — years, and they want to live. They want to have a good quality of life and just taking someone out of the intensive care environment just makes a lot of sense. It’s a much more holistic and patient and family-friendly environment compared to an intensive care unit. This makes perfect sense. Intensive care units are depressing environments where you only want to be for short periods of times ideally for critical illness, and then you want to get out of there as quickly as possible.
Now, there are the exceptions to the rule which, Eva, your daughter seems to fall in that category where she’s the exception. She’s been there for months on end, and she’s not going anywhere.
Continue reading at: https://intensivecareathome.com/my-daughters-on-a-ventilator-tracheostomy-dialysis-icu-says-she-cant-be-weaned-can-she-go-home/
11
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Is a Tracheostomy Beneficial for Motor Neuron Disease Patients?
https://intensivecareathome.com/is-a-tracheostomy-beneficial-for-motor-neuron-disease-patients/
Is a Tracheostomy Beneficial for Motor Neurone Disease Patients?
Tracheostomy ventilation in MND - Oxford University Hospitals
https://www.ouh.nhs.uk/services/departments/neurosciences/neurology/mnd/support/documents/tracheostomy-ventilation-in-mnd.pdf
Who will benefit from tracheostomy ventilation in motor neuron disease?
https://thorax.bmj.com/content/66/11/932
Tracheostomy ventilation in motor neurone disease: a snapshot of UK practice
https://pubmed.ncbi.nlm.nih.gov/33969757/
Tracheostomy in motor neurone disease
https://pubmed.ncbi.nlm.nih.gov/31273080/
Tracheostomy ventilation in motor neurone disease
https://pubmed.ncbi.nlm.nih.gov/31273080/
Respiratory management & NIV
https://www.mndaustralia.org.au/mnd-connect/for-health-professionals-service-providers/managing-symptoms/breathing-management-in-mnd
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Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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Good morning, good evening, good afternoon, wherever you are. Thank you so much for coming to another YouTube live stream for Intensive Care at Home today.
Today’s title is “Is a tracheostomy beneficial for motor neuron disease patients?” Before I dive into today’s topic, I also want to welcome our viewers that watch this on replay.
I also want to quickly talk about what makes me qualified to talk about today’s topic, “Is a tracheostomy beneficial for motor neuron disease patients?” My name is Patrik Hutzel. I am a critical care nurse by background. I have worked in critical care for nearly 25 years in three different countries, and I have worked in intensive care units, but also in the Intensive Care at Home space for decades now. I have a large degree of experience with motor neuron disease ranging back nearly as close as 25 years when I first started out in intensive care as well as with Intensive Care at Home in Germany. But I’ll come to that later.
So, what makes me qualified to talk about today’s topic? Like I said, I am a critical care nurse by background, having worked in critical care for nearly 25 years in three different countries. I worked as a nurse manager in intensive care. I worked with Intensive Care at Home as early as 2001. I am the founder and managing director of intensivecareathome.com where we also provide Intensive Care at Home services for motor neuron disease patients at home. So, I have first-hand experience looking after these patients, including looking after motor neuron disease patients with ventilation and tracheostomy as early as 2001 in Germany. But again, I will talk more about that in a minute.
With Intensive Care at Home currently, we are operating all around Australia. We’re operating in all major capital cities as well as in regional and rural areas. We are an NDIS (National Disability Insurance Scheme) approved nursing service. We are a TAC (Transport Accident Commission) approved service in Victoria, WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as the DVA all around Australia. We have also received funding through public hospitals, private health insurances, as well as departments of health.
I’m also the founder of intensivecarehotline.com, a consulting and advocacy service for families in intensive care. You can find out more information at intensivecarehotline.com.
With Intensive Care at Home, we are also providing Level 2 and Level 3 Specialist Support Coordination, NDIS support coordination, but we’re also providing case management for TAC, WorkSafe clients, as well as iCare and NIISQ case management.
Continue reading at: https://intensivecareathome.com/is-a-tracheostomy-beneficial-for-motor-neuron-disease-patients/
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The NDIS Wants Support Workers Do the Work of ICU Nurses! Australian Federal Court Ruled Against It!
https://intensivecareathome.com/the-ndis-national-disability-insurance-scheme-wants-support-workers-do-the-work-of-icu-nurses-australian-federal-court-ruled-against-it/
The NDIS Wants Support Workers Do the Work of ICU Nurses! Australian Federal Court Ruled Against It!
National Disability Insurance Agency v KKTB, by her litigation representative CVY22 [2022] FCAFC 181
https://www.judgments.fedcourt.gov.au/judgments/Judgments/fca/full/2022/2022fcafc0181
Code of conduct
https://www.ahpra.gov.au/Resources/Code-of-conduct.aspx
Professional standards
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Book your free 15-minute phone consultation here
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Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies. Also, otherwise medically complex adults and children at home including home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure) ventilation, home tracheostomy care when adults and children are not ventilated, also Home TPN, home IV potassium, home IV magnesium infusions, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care at home, and that also includes ventilation weaning at home.
We have also provided an emergency department bypass service in the past for the Western Sydney Local Area Health District. We’ve successfully kept patients at home as opposed to them going to the Emergency Department. So, Intensive Care at Home is really making a big difference for our clients and their families, and of course, also for hospitals, intensive care unit, but also for emergency departments.
Now, in today’s video, I actually want to talk about a recent court case. When I say recent, the court case was in November 2022, at the time of this recording, it’s April 2024. The court case is around the National Disability Insurance Agency, also known as NDIS, versus some NDIS participants. The court case was around funding registered nurses are not under the NDIS and what is reasonable and necessary.
Now, let me give you some background why this is important for the work that we are doing and why this is important for our clients, in particular. In 2020, there were three of our clients that were ventilated and/or had a tracheostomy in the community. They were not funded for 24-hour nursing care with intensive care nurses, as is evidence-based, because the NDIS rejected that. Those clients were only funded for night shifts and did have no daytime ICU nurse.
We predicted at the time that if the NDIS wasn’t funding 24-hour intensive care nurses that these clients are at risk of dying during the daytime when there’s no intensive care nurse present. Unfortunately, our predictions became a reality very quickly. All those three clients passed away in the absence of an intensive care nurse because support workers, family members, or even registered nurses without ICU experience could not manage the medical emergency that came up for patients that have a tracheostomy and/or were ventilated.
They’re technically intensive care patients because if they had gone back to hospital, they would have presented back into intensive care because the general ward or the general floor areas do not have the skills or the expertise to look after them.
Continue reading at: https://intensivecareathome.com/the-ndis-national-disability-insurance-scheme-wants-support-workers-do-the-work-of-icu-nurses-australian-federal-court-ruled-against-it/
15
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1
comment
My Dad’s Ventilated with Tracheostomy,He Can’t Wean Because of Stroke&Parkinson’s Should He Go Home?
https://intensivecareathome.com/my-dads-ventilated-with-tracheostomy-he-cant-wean-because-of-stroke-parkinsons-should-he-go-home/
My Dad’s Ventilated with Tracheostomy, He Can’t Wean Because Of Stroke & Parkinson’s, Should He Go Home?
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And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies, also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated. We also provide Home TPN (total parenteral nutrition), Home IV potassium, Home IV magnesium infusions as well as IV antibiotics at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home.
We have also provided an emergency department bypass service for the Western Sydney Local Area Health District because we have been sending our critical care nurses into the home to avoid emergency department admissions as well.
So, today I have a question from Jane that I want to answer, and Jane says,
“Hi, Patrik.
My dad is 66 years old. He’s has been in ICU for 14 days. Two days ago, they did a tracheostomy because he couldn’t breathe on his own. He’s still on the ventilator after the tracheostomy because he still can’t breathe on his own. The doctor said they will try and wean him off step by step, and it is really important if his heart and brain can endure this during this challenging time. He is having neurological problems. The brain is not giving signals to the respiratory system to breathe.
All his other organs seem to be OK. His vital signs seem to be stable as well. He does open his eyes. He sheds tears sometimes. He responds to stimuli, answers to the commands given by doctors and nurses but when told to breathe, he tries but gets tired immediately because his muscles are too weak.
He was also diagnosed late last year with Parkinson’s disease, diabetes, and he had some brain damage because of some brain strokes he had. The last three months, he was also losing weight because he couldn’t eat and had sleep deprivation during the night and slept a lot during the day.
Is there hope for him? How much can it take him to recover? What can we do for him? Can we take him home if he can’t be weaned off the ventilator in ICU?
From, Jane.”
Well, Jane, thank you so much for reaching out with your question.
It’s probably way too early to see where this is going, given that he’s only had a tracheostomy a couple of days ago but given that he had a stroke and he’s been diagnosed with Parkinson’s, weaning off the ventilator might be slow and challenging.
Also, if he couldn’t sleep at night but slept a lot during the day, I’m also wondering whether he might have sleep apnea, and whether he has a high CO2 or carbon dioxide is high because that might also mean he needs some form of ventilation going forward. Obviously, your question there to ask is, what is his CO2 like? And if he can’t come off the ventilator, they probably need to do a sleep study to work out what he needs going forward, whether he needs ventilation at all, assuming he can’t be weaned off the ventilator. You do mention that he’s too weak at the moment.
Continue reading at: https://intensivecareathome.com/my-dads-ventilated-with-tracheostomy-he-cant-wean-because-of-stroke-parkinsons-should-he-go-home/
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Can My Ventilated Dad in ICU with MND Get a Tracheostomy and Go Home with INTENSIVE CARE AT HOME?
https://intensivecareathome.com/can-my-ventilated-dad-in-icu-with-mnd-motor-neurone-disease-get-a-tracheostomy-and-go-home-with-intensive-care-at-home/
Can My Ventilated Dad in ICU with MND Get a Tracheostomy and Go Home with INTENSIVE CARE AT HOME?
Book your free 15-minute phone consultation here
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Call directly 24/7
+1 415-915-0090 USA/Canada
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Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care services for long-term ventilated adults and children with tracheostomies, also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated. We also provide Home TPN (total parenteral nutrition) which is IV nutrition. We also provide IV potassium, IV magnesium in children at home, as well as IV antibiotics at home. We also provide port management, central line management, PICC (peripherally inserted central catheter) line management, Hickman’s line management, as well as palliative care services at home. It also includes ventilation weaning at home.
We have also provided an emergency department bypass service for the Western Sydney Local Area Health District and where we send our critical care nurses into the home to prevent emergency department admissions.
Now, today I have a question from Jerry, and Jerry says,
“Hi Patrik,
My dad is 68 years old, and he has been in ICU for eight days. Now, he has been having motor neurone disease for the last 10 months. He now developed sepsis and was hospitalized for the second time after four months. He has a PEG (Percutaneous Endoscopic Gastrostomy) tube, but his large intestine was not getting enough oxygen and he had an internal ischemia. Part of his large intestine was removed. They did a colostomy procedure on him. He was in a medically induced coma for the last four days during these procedures. They did a CT scan of the abdomen to discover why there is not enough oxygen.
Because of the MND (Motor Neurone Disease), he can’t talk, walk, or swallow. His breathing and oxygen were not at the safest number, so he was intubated on a ventilator again yesterday. He’s on 55% to 60% FiO2 (Fraction of Inspired Oxygen) or oxygen on the ventilator. The GI doctor wants to strongly recommend taking him off life support. It’s only been a day so far. He is intubated with no sedation. The nurses are saying he is weak but still he’s tolerating the intubation with just pain medications, and he’s drowsy and opens his eyes.
What can we do?”
Well, that’s a great question, Jerry. We have seen this situation many times. So, for example, one solution for your dad might be a tracheostomy and then go home with Intensive Care at Home. So, let me elaborate on this in more detail.
We are currently looking after clients at home with MND (motor neurone disease) that are ventilated and have a tracheostomy, and that is their choice. They do want to live. Some MND clients or MND patients for that matter, they get diagnosed with MND and then they don’t get a tracheostomy. Although they don’t want a tracheostomy, they go on BIPAP and eventually BIPAP can be removed, and they can pass away if that’s what they want. But many MND clients don’t want that, they want to live, and they want the tracheostomy, and they want to spend quality time with their family, which is an option for your dad in this situation as well.
Continue reading at: https://intensivecareathome.com/can-my-ventilated-dad-in-icu-with-mnd-motor-neurone-disease-get-a-tracheostomy-and-go-home-with-intensive-care-at-home/
12
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1
comment
How ICAH is Helping Another Tracheostomy Client to Improve their Quality of Life at Home!
https://intensivecareathome.com/how-intensive-care-at-home-is-helping-another-tracheostomy-client-to-improve-their-quality-of-life-at-home/
How ICAH is Helping Another Tracheostomy Client to Improve their Quality of Life at Home!
Book your free 15-minute phone consultation here
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Get 1:1 consulting and advocacy
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https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies. Otherwise medically complex adults and children at home, which includes home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), also home tracheostomy care (178) for adults and children that are not ventilated, Home TPN (total parenteral nutrition), home IV potassium infusions, home IV magnesium infusions, home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management as well as palliative care services at home. We are also sending our critical care nurses into the home or into a residential aged care to provide an emergency department bypass service.
So, in today’s blog post, I want to talk about a recent client that we just started servicing at home. The client is a young man who has unfortunately become a quadriplegic. He’s now having a tracheostomy and is dependent on the tracheostomy to live his daily life.
Now, interestingly enough, the family said that when he spent a lot of time in ICU, they were told that their son and brother wouldn’t have any quality of life, and they were encouraged to withdraw life support. But the family was adamant, saying, “No, we’re not going to withdraw life support. We want him to live. We want to take him home.”
After a long journey in hospital, he finally came home with the help of our service. Initially, they didn’t know that our service existed so they were trying to manage it themselves and with some support workers that didn’t work, of course, the client ended up back in the hospital all the time.
Now, we just started there, and it looks like the situation is getting much better with having critical care nurses, 24 hours a day, which is what is needed for tracheostomy care at home when you look at the evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com. You will see that those Mechanical Home Ventilation Guidelines are evidence-based and are a result of nearly 30 years of Intensive Care at Home nursing in Germany but also of Intensive Care at Home nursing for the last 10 years here in Australia with Intensive Care at Home because our service is evidence-based. This is what clients in the community need.
If they don’t get evidence-based nursing care with specialist critical care nurses, clients are at risk of dying. I’m unfortunately not exaggerating. I’ve made videos about clients that don’t get the appropriate NDIS (National Disability Insurance Scheme) funding for specialized nursing care have died in the community, and I’ve made videos about that before. I have also evidence to back up what I’m saying here.
So, it is really important that if you have a loved one in intensive care with a tracheostomy or if you have a loved one on a hospital ward, on a respiratory ward with a tracheostomy and you see no way forward, you should absolutely contact us here so that we can help you to get your loved one home with the appropriate care so they’re not going back to hospital all the time or even worse.
Continue reading at: https://intensivecareathome.com/how-intensive-care-at-home-is-helping-another-tracheostomy-client-to-improve-their-quality-of-life-at-home/
14
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Why You Need to Select ICU Nurses at Home for Ventilation&Tracheostomy&Not General Registered Nurses
https://intensivecareathome.com/why-you-need-to-select-icu-nurses-at-home-for-ventilation-tracheostomy-not-general-registered-nurses/
Why You Need to Select ICU Nurses at Home for Ventilation & Tracheostomy & Not General Registered Nurses
Book your free 15-minute phone consultation here
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Call directly 24/7
+1 415-915-0090 USA/Canada
+44 118 324 3018 UK
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Email support@intensivecarehotline.com
Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
Twitter: https://twitter.com/icuhotline
Here is also a link to case studies
https://intensivecarehotline.com/category/questions/
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Hi, it’s Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long term ventilated adults and children with tracheostomies. Otherwise, medically complex adults and children at home, which includes home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), also home tracheostomy care for adults and children that are not ventilated. Also, home TPN, home IV potassium infusion, home IV magnesium infusions, home IV antibiotics. We also provide port management, central line management, as well as Hickman’s line management as well as palliative care services at home.
Today, I actually want to talk about a situation that we encountered recently, which illustrates once again why selecting a specialist service is so important and selecting a specialist service that is specialized on ventilation, tracheostomy at home that enables patients to leave intensive care if they’re stuck in intensive care long-term.
So, here’s the following situation. We had an inquiry recently for a young man who is in his 30s who is a quadriplegic. He is having a tracheostomy, and he has been discharged from hospital.
Initially, the family was hiring registered nurses online. There are a number of platforms online where the NDIS (National Disability Insurance Scheme) here in Australia allows nurses to put their skills on, like, an app, and then clients can hire directly.
They initially hired a number of registered nurses to look after their son. Now, it turns out as soon as the registered nurses showed up on the scene that they didn’t know what the tracheostomy was. Well, that’s crystal clear to me because no registered nurses are exposed to tracheostomies if they haven’t worked in intensive care for a period of time.
That is why here at Intensive Care at Home, we exclusively work with critical care nurses that have a minimum of two years critical care nursing experience because that would give them sufficient exposure to work with tracheostomies.
So, needless to say that the care of the family’s son was falling apart pretty quickly, and he bounced back into hospital. Now, needless to say that the family then obviously was looking around what other options are there?
Then, eventually they found us realizing because we are a specialist service working with critical care nurses that we are the right solution for their son’s care, and that’s why going on an app and trying to select nurses there, that’s fine. It’s a bit like the Uber app, where you push the button, and the car comes here. It’s a bit like when you push the button, and the nurse comes. However, no one is checking their qualifications. No one is matching their qualifications with the right client, and that’s one of the downsides.
Now, the other thing is with those online apps, they are not sending you nurses that are working with a third-party accredited service provider, which is what we are here at Intensive Care at Home..."
Continue reading at: https://intensivecareathome.com/why-you-need-to-select-icu-nurses-at-home-for-ventilation-tracheostomy-not-general-registered-nurses/
16
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My Dad’s in ICU Ventilated with COPD & Emphysema! Is Having a Tracheostomy and Going Home an Option?
https://intensivecareathome.com/my-dads-in-icu-ventilated-with-copd-chronic-obstructive-pulmonary-disease-emphysema-is-having-a-tracheostomy-and-going-home-an-option/
My Dad’s in ICU Ventilated with COPD & Emphysema! Is Having a Tracheostomy and Going Home an Option?
Book your free 15-minute phone consultation here
http://intensivecarehotline.com/scheduling-appointment/
Call directly 24/7
+1 415-915-0090 USA/Canada
+44 118 324 3018 UK
+6141 094 2230 Australia
Email support@intensivecarehotline.com
Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
Twitter: https://twitter.com/icuhotline
Song: Jarico - Island Music
supported by@FreeBackgroundMusicForCreators
#BackgroundMusicWithoutLimitations
https://bit.ly/2XoXFnb
#icu
#intensivecare
#criticalcare
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children with tracheostomies, and also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, and IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home, and sometimes even ventilator weaning at home.
We also send our critical care nurses into the home to avoid emergency department admissions (ED admissions). So, we’re also providing an ED bypass service into people’s homes, as well as into residential aged care or any other facilities where you would like our service.
Now, I want to answer a question today that I had from Kat. Let me read that Kat’s email and answer a question, she says:
“Hi Patrik,
My dad was admitted to ICU and intubated 10 days ago for influenza A with COPD and emphysema. We were told they would wean him off sedation on Day 4, but then we were told he wasn’t ready. The ICU doctor says he is about 20% of lung function. They are now saying that a tracheostomy is the next step but have not tried to wean him off sedation or ventilation.
Being trapped in an ICU on the ventilator to die is his biggest fear as he saw both of his parents pass away in ICU. I am looking for options to get him a better quality of life. If he cannot come off the ventilator, I want to be his strongest advocate in receiving the care and treatment he needs, both medically and mentally.
Can you help? From Kat.”
Well, thank you, Kat, for writing in and for asking such a detailed question.
Now first off, if his lung function is at 20% capacity, that’s really low. The question is why? I mean, he’s got a history of influenza A, COPD, emphysema, is there something else going on? Does he have pneumonia? Does he have ARDS (Acute Respiratory Distress Syndrome)? Do they think there is a way forward to improve his lung function? Does he need to go on ECMO (Extracorporeal membrane oxygenation) to improve his lung function? Does he need nitric oxide? Epoprostenol? Any other nebulizers that might help him to improve his lung function? It’s all depending on his condition.
Tracheostomy might be the next step here if he can’t be woken up, and if he can’t be weaned off sedation. Also, keep in mind, it would be difficult to wean him off sedation if he’s at 20% of lung function. So, here’s the deal, if he had 20% of lung function and they take off sedation and he can’t breathe, with no lung function, it’ll only distress him. Therefore, keeping him sedated and working towards the tracheostomy might be the better way to go here...
Continue reading at: https://intensivecareathome.com/my-dads-in-icu-ventilated-with-copd-chronic-obstructive-pulmonary-disease-emphysema-is-having-a-tracheostomy-and-going-home-an-option/
16
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ED's in Australia are Overrun& No Longer Safe, ED Physician Says! How INTENSIVE CARE AT HOME Helps!!
https://intensivecareathome.com/eds-emergency-department-in-australia-are-overrun-no-longer-safe-ed-physician-says-how-intensive-care-at-home-helps/
ED's in Australia are Overrun& No Longer Safe, ED Physician Says! How INTENSIVE CARE AT HOME Helps!!
Book your free 15-minute phone consultation here
http://intensivecarehotline.com/scheduling-appointment/
Call directly 24/7
+1 415-915-0090 USA/Canada
+44 118 324 3018 UK
+6141 094 2230 Australia
Email support@intensivecarehotline.com
Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
Twitter: https://twitter.com/icuhotline
Here are the phone options
One day 1:1 consulting and advocacy FACE TO FACE or via zoom $20,000 per day
https://intensivecarehotline.thrivecart.com/one-day-11-consulting-in-person-face/
30 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $3,299
https://intensivecarehotline.thrivecart.com/thirty-days-11-phone-consulting-us/
14 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $1,999
https://intensivecarehotline.thrivecart.com/fourteen-days-11-phone-consulting-us/
7 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $1,299
https://intensivecarehotline.thrivecart.com/seven-days-11-phone-consulting-us/
4 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $999
https://intensivecarehotline.thrivecart.com/four-days-11-phone-consulting-us/
2 days 24/7 unlimited 1:1 phone and email support, including speaking to doctors and nurses directly, as well as participating in family meetings over the phone for $499
https://intensivecarehotline.thrivecart.com/two-days-11-phone-consulting-us/
You don’t have to use the 2, 4, 7, or 14 days in a row and you can use the days at your own pace.
Here's the hour option
Book 60 minutes 1:1 phone consulting and advocacy for $249 (can be credited towards any of the options above)- click on the link
https://intensivecarehotline.thrivecart.com/one-hour-11-phone-consulting-us/
Or you can join the membership here where you have access to me in the membership area for only US $199/ month where I advise daily and where you also have access to more material including all of our eBooks! Furthermore, you’ll get a 20% discount for 1:1 phone consulting and advocacy if you are a member!
https://intensivecarehotline.thrivecart.com/membership-us/
Here is also a link to case studies
https://intensivecarehotline.com/category/questions/
https://intensivecareathome.com/category/case-studies/
Song: Jarico - Island Music
supported by@FreeBackgroundMusicForCreators
#BackgroundMusicWithoutLimitations
https://bit.ly/2XoXFnb
#icu
#intensivecare
#criticalcare
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality service for long-term ventilated adults and children with tracheostomies also otherwise medically complex adults and children at home including home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home and that also includes ventilation weaning at home.
Continue reading at: https://intensivecareathome.com/eds-emergency-department-in-australia-are-overrun-no-longer-safe-ed-physician-says-how-intensive-care-at-home-helps/
7
views
A Blueprint for Hospital Discharge with Tracheostomy with INTENSIVE CARE AT HOME!
A Blueprint for Hospital Discharge with Tracheostomy with INTENSIVE CARE AT HOME!
Book your free 15-minute phone consultation here
http://intensivecarehotline.com/scheduling-appointment/
Call directly 24/7
+1 415-915-0090 USA/Canada
+44 118 324 3018 UK
+6141 094 2230 Australia
Email support@intensivecarehotline.com
Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
Twitter: https://twitter.com/icuhotline
Song: Jarico - Island Music
supported by@FreeBackgroundMusicForCreators
#BackgroundMusicWithoutLimitations
https://bit.ly/2XoXFnb
#icu
#intensivecare
#criticalcare
10
views
How Can My 9-Month-Old Baby Be Weaned Off the Ventilator & Tracheostomy in PICU? Can She Go Home?
https://intensivecareathome.com/how-can-my-9-month-old-baby-be-weaned-off-the-ventilator-tracheostomy-in-picu-can-she-go-home/
How Can My 9-Month-Old Baby Be Weaned Off the Ventilator & Tracheostomy in PICU? Can She Go Home?
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies, otherwise medically complex adults and children at home, which includes Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), also home tracheostomy care for adults and children that are not ventilated, also Home TPN, Home IV potassium infusions, Home IV magnesium infusions, Home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management, as well as palliative care services at home.
Now, in today’s blog post, I want to answer a question from Sonia. Let me read out the question from Sonia who says,
“Hi, Patrik,
I have my nine-month-old baby girl in intensive care. She had four failed extubations. So, she had to have a tracheostomy and has been stuck on a ventilator since May last year. Her respiratory rate has been high since birth. When she’s asleep, it’s between 50 to 60 breaths per minute, but when she’s awake, it’s anything between 70 to 90 breaths per minute. She currently has a PEEP of 10, and pressure control and pressure support of 6, respectively. Do you have any advice on how we are able to wean her off? She has no airway issues; CT scan was okay. The only thing that the doctor say is that her lung volume is less than a baby her age.” Thank you so much, Sonia, for sending through this question.
So well, first off, you need to establish what ventilation setting she is in. Is she in a controlled ventilation mode such as SIMV (Synchronized Intermittent Mandatory Ventilation) or ACV (Assist Control Ventilation) where the machine is delivering a set number of breaths per minute, or is she in a CPAP or pressure support ventilation mode where she’s triggering most of her breaths herself? Is she passing any spontaneous breathing trials? You haven’t elaborated on that. Has she been off the ventilator at all? Even if it’s only for 5 or for 10 minutes, even that would be a starting point.
In terms of weaning your daughter off the ventilator, it should be similar. It’s not dissimilar to many other adult patients; mobilization, stopping sedation, stopping opiates. Mobilization would be first and foremost, reducing PEEP, reducing pressure support, reducing oxygen levels as much as you can and getting her to breathe on CPAP pressure support more and more. Once she can do that, more than 24 hours a day, put her on a T-piece and see what happens.
Now, if that can’t be achieved, other strategies here could be lung volume is decreased. She could potentially have a tracheostomy. Many ICUs are doing that, do a bronchoscopy which is putting a video camera down in the lungs and see what’s going on there. Also, with lung volume being decreased, why is that? Is she having secretions? Why is lung volume decreased? Was she prematurely born? Are lungs affected, not developed? You haven’t elaborated on any of that, but those would be things that I would be asking them and see what the answers are.
If your daughter cannot be weaned off the ventilator, then clearly the Intensive Care at Home is the best next step.
Continue reading at: https://intensivecareathome.com/how-can-my-9-month-old-baby-be-weaned-off-the-ventilator-tracheostomy-in-picu-can-she-go-home/
7
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Can INTENSIVE CARE AT HOME Do IV (Intravenous) Fluids for Palliative Care at Home?
Can INTENSIVE CARE AT HOME Do IV (Intravenous) Fluids for Palliative Care at Home?
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14
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Latest Evidence on Hospital-In-Home Programs Implementation Sustainability and Patient Perspectives
https://intensivecareathome.com/latest-evidence-on-hospital-in-home-programs-implementation-sustainability-and-patient-perspectives/
Latest Evidence on Hospital-In-Home Programs Implementation Sustainability and Patient Perspectives
Latest evidence on Hospital in the home programs: implementation, sustainability and patient perspectives — Cochrane Australia
https://www.cochraneaustralia.org/articles/latest-evidence-on-hospital-in-the-home-programs-implementation-sustainability-and-patient-perspectives
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It’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units, whilst providing quality services for long-term ventilated adults and children with tracheostomies. Also, otherwise medically complex adults and children at home, including home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management as well as palliative care services at home, and that also includes ventilator weaning at home.
Now, today, I want to focus on an Australian study. In more detail, I want to focus on a study that talks about, “The latest evidence on hospital in the home programs: implementation, sustainability, and patient perspectives.”
So, I want to I’ll just read out the article and I will also link to the article so that you can see where the source of this article is coming from. So, let me read this out.
“Two companion Cochrane reviews and the new Cochrane Library editorial on Hospital at home programs were published this week. Here, Cochrane authors Dr. Jason Wallis and Professor Sasha Shepperd share their key findings.”
There’s a heading now in the picture, “Hospital in the home or also known as HITH programs have been on the rise in response to the COVID-19 Pandemic”.
“’Hospital at home or – Hospital in the home (HITH) as it’s better known here in Australia – is a service designed for people whose condition would normally need treatment in a hospital bed,’ explains Jason Wallis, researcher at Monash University’s School of Public Health. ‘Instead, with HITH, they typically receive visits from a doctor, nurse and allied health professionals at home instead – just as they would if they were in hospital.’
‘We know there’s been a significant increase in HITH programs around the globe as an alternative to hospital admission, with more services being set-up during the COVID-19 pandemic to relieve the pressure on hospital beds and increase capacity. There are two types of programs. The first is called ‘admission avoidance’ as patients are referred by emergency doctors or general practitioners for HITH, thereby avoiding admission to a hospital ward. The other type is called ‘early discharge’ and is designed to shorten the length of time patients need to stay in hospital.’
For us here at Intensive Care at Home, it’s probably the latter but we have certainly focused on admission avoidance as well because we are also sending our critical care nurses into people’s home to avoid emergency department presentations. So, we’re doing both here at Intensive Care at Home.
Continue reading at: https://intensivecareathome.com/latest-evidence-on-hospital-in-home-programs-implementation-sustainability-and-patient-perspectives/
13
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How Important is ICU/Hospital Discharge Planning for INTENSIVE CARE AT HOME Clients?
https://intensivecareathome.com/how-important-is-icu-hospital-discharge-planning-for-intensive-care-at-home-clients/
How Important is ICU/Hospital Discharge Planning for INTENSIVE CARE AT HOME Clients?
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Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies, and also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home, and that also includes ventilator weaning at home.
Now, today I want to answer a question that we get quite frequently from our clients, but also from hospitals as well. They ask, “How important is discharge planning for Intensive Care at Home clients or Intensive Care at Home patients?”
Well, discharge planning when going home from hospital is everything, that really sets the scene, and it really is a make-or-break point. We have done so many successful transitions from ICU to home to improve the quality of life for our clients and in some instances, improve the quality of end of life for our clients. It’s really a critical point to make it a successful transition for Intensive Care at Home clients, which includes the patient and the family, of course, but it also includes the hospitals because the goal for the hospital is to discharge patients into a safe environment, making sure they’re not coming back, that’s the whole purpose of intensive care. So, let’s look at this in more detail.
So, first of all, you have to identify the right client or the right patient that they can benefit from Intensive Care at Home, that they can improve their quality of life at home or, in some instances, quality of end of life at home. Predominantly, it’s for patients with ventilation and tracheostomy adults and children. They have been identified as having the inability to wean off the ventilator and the tracheostomy for now. That’s not to say they might not be able to do that later, but it would take long periods of time, and hospitals and ICUs, in particular, are often not the right place because they are very depressive environments with no quality of life.
One of the obstacles for patients to wean off a ventilator is simply they’re not in a patient and family friendly environment. Anyone that set a foot into an ICU knows it’s just there to help treat critical illness and save lives, and that’s fantastic. But at some point, when someone is stuck in their long term, it is no longer the right environment for them. It’s also no longer the right environment for the families because they more or less “live in ICU” and that’s not a good thing either.
Moreover, ICU beds are in short supply. Critical care beds are in short supply. Critical care beds are the most sought-after beds in a hospital. So therefore, freeing up an ICU bed and moving patients home if they can’t go to a hospital ward or hospital floor makes a lot of sense and is a win-win situation.
Continue reading at: https://intensivecareathome.com/how-important-is-icu-hospital-discharge-planning-for-intensive-care-at-home-clients/
20
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INTENSIVE CARE AT HOME Now Accredited for ACIS 4.0 & Therefore is on the Provider List for ICARE NSW
https://intensivecareathome.com/intensive-care-at-home-now-accredited-for-australian-community-industry-certification-scheme-acis-4-o-therefore-is-on-the-provider-list-for-icare-nsw-new-south-wales/
INTENSIVE CARE AT HOME Now Accredited for ACIS 4.0 & Therefore is on the Provider List for ICARE NSW
Book your free 15-minute phone consultation here
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And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
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#intensivecare
#criticalcare
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies, otherwise medically complex adults and children at home, including Home TPN (total parenteral nutrition), Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), also home tracheostomy care for adults and children that are not ventilated. We are also providing IV potassium infusions, IV magnesium infusions at home, and IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management, as well as palliative care services at home.
Now, in today’s blog post, I want to celebrate and announce that Intensive Care at Home is now accredited for the Australian Community Industry Certification Scheme ACIS 4.0. This accreditation scheme enables us to provide nursing care for iCare New South Wales at the highest levels as part of the insurance scheme. We are the specialized and leading Intensive Care at Home Nursing Service, sending critical care nurses into the home for, like I said, mechanical ventilation, tracheostomy care, BIPAP, CPAP, Home TPN, Home IV potassium, magnesium, Home IV antibiotics, port management, PICC line management, central line management, Hickman’s line management as well as palliative care.
So, as far as I’m aware, in 2024, in Australia, there’s no other service provider that has actually achieved third party accreditation for Intensive Care at Home nursing. We have built unique intellectual property, unique policies, and procedures. We are employing hundreds of years of intensive care nursing experience that we are combining, we are bringing into the community, that is unmatched in the community. There’s no other service that brings the area of expertise and the area of skill into the community than we do, enabling long-term intensive care patients to improve their quality of life, and, in some instances, quality of end of life at home.
This is underpinned by us also providing an emergency department bypass service for the Western Sydney Local Area Health District, where we are sending our critical care nurses into the home to avoid ED emergency department admissions and emergency department presentations, again, taking the pressure off hospitals.
Like I said, we’re all about quality here, look at other services that claim they can do tracheostomy, ventilation care at home, they have no accreditation. They don’t work as per evidence-based practice guidelines like we do when you have a look at our Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com, you will find that the guidelines that we’re working under are internationally recognized and are a result of over 25 years of Intensive Care at Home nursing in Germany, as well as over 10 years of Intensive Care at Home nursing in Australia.
Continue reading at: https://intensivecareathome.com/intensive-care-at-home-now-accredited-for-australian-community-industry-certification-scheme-acis-4-o-therefore-is-on-the-provider-list-for-icare-nsw-new-south-wales/
117
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1
comment
Another Testimonial from a Very Happy INTENSIVE CARE AT HOME 24/7 Nursing Client!
Another Testimonial from a Very Happy INTENSIVE CARE AT HOME 24/7 Nursing Client!
Book your free 15-minute phone consultation here
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Call directly 24/7
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Email support@intensivecarehotline.com
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http://intensivecarehotline.com/one-on-one-counselling/
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Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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14
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Mom's in ICU for 6 weeks, Unable to Wean Off Ventilation & Tracheostomy After CABG, I Want Her Home
https://intensivecareathome.com/moms-in-icu-for-6-weeks-unable-to-wean-off-ventilation-tracheostomy-after-cabg-coronary-artery-bypass-graft-i-want-her-home/
Mom's in ICU for 6 weeks, Unable to Wean Off Ventilation & Tracheostomy After CABG, I Want Her Home
Book your free 15-minute phone consultation here
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Call directly 24/7
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Get 1:1 consulting and advocacy
1:1 phone counselling
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Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
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#intensivecare
#criticalcare
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children with tracheostomies. Also, otherwise medically complex adults and children at home including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home, and that also includes ventilator weaning at home.
Now today, I want to answer a question from one of our readers, Morgan, who says,
“Hi Patrik,
My mother is in ICU after an emergency CABG, CABG stands for Coronary Artery Bypass Graft, also known as open heart surgery, about 6 weeks ago. We have been told by the ICU that we should prepare for hospice because she is ventilator dependent with a tracheostomy.
Before all of this, she had no prior health problems other than breast cancer 15 years ago. She had chemotherapy and radiation. She also had complications during a cardiac catheter procedure which resulted in a coronary dissection, which is a rupture of a coronary artery and cardiogenic shock, which is the reason for the emergency coronary artery bypass grafts, also known as CABG or open heart surgery.
She had multiple complications postoperative including bleeding heart failure and 3 days of CRRT. CRRT stands for Continuous Renal Replacement Therapy. It is also known as dialysis or hemofiltration. Her kidney functions are close to normal now. She was on sedation for 14 out of 21 days in cardiac ICU before going to the general ICU.
On admission to the general ICU, we were told that she had severe sepsis and 2 small strokes that were discovered once the CT scan was done. She also had to get a tracheostomy during her stay in the cardiac ICU since she was unable to come off the ventilator before going to the general ICU.
Since the emergency coronary artery bypass graft, her ejection fraction is 40% but we are now being told she has metabolic encephalopathy since she’s not consistently responsive to commands and has been back on sedation for 14 of her 29 days in the general ICU.
She has also been failing her ventilation weaning program. I believe this has to do with the fact she has been back on sedation due to anxiety and becoming tachypneic. The settings are FiO2 of 30% and PEEP of 5.
We feel the ICU team are giving up on her too soon because she’s costing them too much time and resources. They are making me feel guilty as if I’m making her suffer but I think there is hope I want to give quality of life to her at home. How can we get her home? Thank you so much for all that you do.”
Thank you, Morgan, for sharing your email.
First off, thank you for detailing your mom’s situation and thank you for thinking ahead. You should give yourself a pat on your shoulder because you can see that in ICU, you can see that her needs are not getting met in ICU.
Continue reading at: https://intensivecareathome.com/moms-in-icu-for-6-weeks-unable-to-wean-off-ventilation-tracheostomy-after-cabg-coronary-artery-bypass-graft-i-want-her-home/
12
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My 66-Year-Old Dad Has Diabetes, Stroke & Parkinson's and is in ICU with a Trache. Can He Go Home?
https://intensivecareathome.com/my-66-year-old-dad-has-diabetes-stroke-parkinsons-and-is-in-icu-with-a-tracheostomy-can-he-go-home/
My 66-Year-Old Dad Has Diabetes, Stroke & Parkinson's and is in ICU With a Trache. Can He Go Home?
Book your free 15-minute phone consultation here
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Call directly 24/7
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Email support@intensivecarehotline.com
Get 1:1 consulting and advocacy
1:1 phone counselling
http://intensivecarehotline.com/one-on-one-counselling/
Become a member for families of critically ill Patients in Intensive Care
https://intensivecarehotline.com/intensivecaresupport-org-membership/
Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review, click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/
Facebook Page: https://www.facebook.com/ICUhotline
Twitter: https://twitter.com/icuhotline
#icu
#intensivecare
#criticalcaremedicine
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children with tracheostomies, otherwise medically complex adults and children at home, including Home TPN (total parenteral nutrition), Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), also home tracheostomy care for adults and children that are not ventilated. We also provide IV potassium infusions, IV magnesium infusions at home, IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home.
Now, in today’s question, I want to answer a question from Nidia who says, “Hi, Patrik, my dad is 66 years of age. He’s in ICU for 13 days. He has a history of some brain strokes in the past. It’s been a year since he was diagnosed with Parkinson’s disease and diabetes. Recently, for the last month or so, he had some problems with swallowing, which made him lose weight. Yesterday, they did a tracheostomy. Is there hope since all other organs are vital, but he can’t breathe on his own? What home care services are available for my dad? I’ve seen that you’re providing tracheostomy care at home.”
So, thank you Nidia for sharing your dad’s situation. So, is there hope? Well, I tell you what there is hope for. There is hope for your dad going home, that is for sure, because that is bread and butter for us to take your dad home with tracheostomy. That’s what we do all day, every day. He will need 24-hour nursing care with specialist nurses because tracheostomy is an artificial airway, and it’s evidence-based to take your dad home with intensive care nurses, 24 hours a day.
You can look up the evidence on our website at intensivecareathome.com. You can look up the Mechanical Home Ventilation Guidelines where the evidence says you need intensive care nurses 24 hours a day at home to make it safe for a tracheostomy, tracheostomy ventilation, and ventilation without a tracheostomy. That is the bottom line. It’s evidence-based Intensive Care at Home services have been around now in Europe and in Australia for over 25 years. It’s evidence-based and it’s a no-brainer.
In terms of your long-term prognosis of your dad, that is obviously something you need to discuss with the neurologist with the Parkinson’s in particular, but also with the previous strokes, as well as the diabetes. You need to discuss that with the relevant specialist.
What we can do for you here is absolutely maximize the quality of life for your dad by going home, because he doesn’t have any quality of life in ICU or in hospital. You and your family don’t have any quality of life by your dad being in hospital or in ICU. So, the long-term outlook on maximizing quality of life at home or depending on what is exactly happening with your dad or potentially quality of end of life is in a home care environment, not in an ICU.
So, even if your dad may not improve, that’s something I can’t comment on here. What we can improve, once again, is quality of life at home and quality of end of life at home as opposed to a stay in ICU, that I can guarantee you because that is what we’ve been doing for over a decade now here with Intensive Care at Home in Australia and we can do the same for your dad,
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