ICU Dr Wants My Husband with Trache & PEG Home with 24/7 ICU Nurses But Doesn't Want Him Back in ICU

https://intensivecareathome.com/icu-doctor-wants-my-husband-with-trache-peg-percutaneous-endoscopic-gastrostomy-home-with-24-7-icu-nurses-but-doesnt-want-him-back-in-icu/

ICU Dr Wants My Husband with Trache & PEG Home with 24/7 ICU Nurses But Doesn't Want Him Back 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 at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home, otherwise medically complex adults and children at home, which includes BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions as well as 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 and we also provide palliative care services at home.

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully in the past for the Western Sydney Local Area Health District, their in-touch program.

So today I have an email from Annette who says,

“Hi Patrik,

I wonder if you can give me some advice. My husband has had a brain stem stroke (92). He has been improving slowly. However, he was placed in a nursing home. He had been there for 17 days. He developed a collapsed lung and chest infection.

He was admitted to the hospital in April and the chest had been treated. He had several infections while in hospital. He is also PEG fed and there seems to be an issue with the PEG feeding. He was not keeping the feeds down and he was vomiting a lot. So, they put the PEG further down on the lower bowels which he seems to be tolerating the feeds now.

He is now ready to go back home. The doctor at home says he will not accept him back unless he will have 24-hour nursing care stating also that he’s not to be admitted to hospital should he become unwell. He also has a tracheostomy.

We as a family have not agreed to sign anything because everyone needs to be treated if they are unwell. Family have agreed to palliative care at home because they say he has long-term medical issues, and we agree to treat him at home first should he become unwell before going to hospital with 24-hour nursing care because he’s got the tracheostomy and the PEG.

I feel we are being pressured into signing a document. We don’t believe we should be pressured into signing anything. Am I right on saying this and how can Intensive Care at Home help in this situation?

I would appreciate any advice.

From Annette”

Well, thank you, Annette for writing in.

Well, the first thing is you shouldn’t be signing anything that you’re not comfortable with signing. The doctor is right in saying that he needs to go home with 24-hour intensive care nurses, that he is correct because it’s evidence based, and the evidence is on our website at intensivecareathome.com.

If you look at the Mechanical Home Ventilation Guidelines, which are evidence-based and are a result of over 25 years of Intensive Care at Home nursing in Germany and over 12 years Intensive Care at Home nursing in Australia, and the model has been proven beyond the shadow of a doubt. So, what does that mean?

Continue reading at: https://intensivecareathome.com/icu-doctor-wants-my-husband-with-trache-peg-percutaneous-endoscopic-gastrostomy-home-with-24-7-icu-nurses-but-doesnt-want-him-back-in-icu/