CAN INTENSIVE CARE AT HOME BE USED FOR LONG-TERM VENTILATED CHILDREN WITH TRACHEOSTOMY?

https://intensivecareathome.com/can-intensive-care-at-home-be-used-for-long-term-ventilated-children-with-tracheostomy/

CAN INTENSIVE CARE AT HOME BE USED FOR LONG-TERM VENTILATED CHILDREN WITH TRACHEOSTOMY?

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In today’s blog post, I want to answer a question from one of our clients and the question today is

Can Intensive Care at Home Be Used for Long-Term Ventilated Children with Tracheostomy?

So, this is a question we get quite frequently, “Can Intensive Care at Home be used for long-term ventilated children with tracheostomy?”

And the short answer is, absolutely yes. We have looked after many long-term ventilated children with tracheostomy at home. Sometimes the children that we are looking after are not having a tracheostomy and they’re just on BIPAP or CPAP ventilation. Sometimes the children that we are looking after are not ventilated at all, but they still need an intensive care nurse, 24 hours a day, because otherwise they would be at high risk of going back to ICU, they have high medical needs.

So, examples for children that are not ventilated at all and don’t have a tracheostomy would be for conditions like Rett syndrome, cerebral palsy, sometimes spinal muscular atrophy, but then those kids often have a cough assist device. They have secretions that need to be suctioned. They have seizures that need to be managed for kids with neurological conditions.

Now, when it comes to long-term ventilated children with tracheostomy, we can shorten the ICU stay significantly by getting those kids home with 24-hour ICU nurses. Pretty much continuing what happens in ICU, at home, and helping families and their children to go home much quicker. Nobody wants to be in ICU. Keep in mind, especially with COVID still being rampant, you want to shorten your stay in ICU as much as possible.

Other children we looked after at home are children that are not ventilated but are having tracheostomy and we’ve successfully decannulated children at home. They just needed a little bit of extra time at home before they were able to be decannulated. That often happens with premature babies, and they have lung disease, and they end up with a tracheostomy temporarily. And we’ve certainly helped those kids to maximize their quality of life at home rather than in ICU before they’ve been decannulated and having the tracheostomy removed.

Other children that we looked after at home include children under palliative care. We helped facilitate palliative care at home for children with tracheostomies. We’ve even done a one-way extubation at home for a toddler. Again, much better place than doing a one-way extubation in intensive care. It’s what families want, and we can certainly facilitate that with Intensive Care at Home as well.

Just honing in again on long-term ventilated children with tracheostomies. Again, we’ve taken kids home from ICU with C1 spinal injury, but also after other respiratory or cardiac conditions where kids simply couldn’t be weaned off the ventilator. And we have facilitated a much better quality of life at home with 24-hour intensive care nursing instead of hospital intensive care.

Now, if you look at our Home Mechanical Ventilation Guidelines that are evidence-based, it’s crystal clear that under those guidelines are the evidence and research-based with ICU nurses, 24 hours a day, and those nurses have a minimum of two years intensive care nursing experience. You can actually continue intensive care in the home, it’s safe, it’s sustainable. It frees up an ICU bed, it cuts the cost of an ICU bed by around 50%, it creates an ICU bed for other admissions into ICU, and most importantly, it creates quality of life for children and their families at home that are no longer stuck in a depressing intensive care units...

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