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Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults & 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 patients and medically complex patients at home, including home TPN.
In last week’s blog, I talked about,
QUICK TIP FOR FAMILIES IN INTENSIVE CARE: CAN MY WIFE BE WEANED OFF THE TRACHEOSTOMY IN ICU?
You can check out last week’s blog by clicking on the link below this video:
In today’s blog post, I want to answer a question from one of our clients and the question today is
10 Things You Need to Know about Tracheostomy In and Outside of Intensive Care! Live stream!
Welcome to another Intensive Care Hotline and Intensive Care at Home livestream. My name is Patrik Hutzel and I’m your host today. I’m looking forward to this livestream today as I do to all of our livestreams, and I want to welcome you once again.
So, today’s topic is, “10 things you need to know about a tracheostomy inside and outside of intensive care.” And for some of you watching you might already be thinking, “Well, how can there be a tracheostomy outside of intensive care?” Well, there definitely can be and we will evaluate on that as we go along today. So, let me just make a note here so that I don’t forget to talk about this later.
We get so many inquiries here at Intensive Care Hotline and Intensive Care at Home about tracheostomies. What they do, what they don’t do? What are the advantages? What are the benefits? What are the disadvantages of a tracheostomy? And I will elaborate more on that today.
And before I dive into today’s topic, you may wonder what makes me qualified to talk about this topic. So, my name is Patrik Hutzel. I am a critical care nurse by background. I have worked in intensive care for coming close to 25 years now in three different countries. Out of those nearly 25 years, I have managed two intensive care units as a nurse unit manager. I am also managing now my own Intensive Care at Home Nursing Service where we provide a genuine alternative to a long-term stay in intensive care for long-term ventilated patients with tracheostomies, which is our topic today. Over the last nine years, I have also, as part of my intensivecarehotline.com, consulted and advocated for hundreds of families in intensive care, all around the world. So, we are specialized on patient and family advocacy in intensive care as well. So that’s a little bit about me.
Now, if you have questions to today’s topic, type them into the chat pad. If you have questions that are not related to today’s topic, type them into the chat pad. I will get to them at the end of this presentation.
Okay, so let’s dive right into today’s topic, “10 things you need to know about tracheostomy inside and outside of intensive care.” Okay, so let’s start with number one.
The number one is, avoid a tracheostomy wherever you can. Now, tracheostomies have their time and their place, and I’ve written about this extensively. I’ve made countless videos about advantages, disadvantages of a tracheostomy. I’ve made countless videos about indications and contraindications for a tracheostomy and so forth. So, if you go to our websites, intensivecarehotline.com and intensivecareathome.com, you will find countless articles and videos about the topic. However, for today’s presentation you need to avoid a tracheostomy whenever you can.
Now when can you avoid a tracheostomy? When we have clients come to us and say, “Hey, the ICU team is telling me I have two options, either a tracheostomy or a palliative care, meaning end of life care.” Well, (A) if you are ever presented with a ride or a die situation, if you will, you always have to question. They are often not the only two options. They’re the two options that are being presented to you. And they’re the two options that are being presented to you because you haven’t asked the right questions, you haven’t done your research yet.
So, the most important question is, has the ICU done everything beyond the shadow of a doubt to get your loved one off the ventilator and the breathing tube before they even suggest a tracheostomy? And you will often find that with a second opinion, which we can give to you, that they haven’t done everything beyond the shadow of a doubt.
The biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care.
Again, I have made videos about how to avoid a tracheostomy, what needs to happen and so forth, and I’ve done a livestream about this maybe six months ago. So, you can have a look on our YouTube channel for this particular video.
So, avoid whenever you can and you might need some help for that. Families in intensive care do need some help. They don’t know what they don’t know. If you think you can manage this challenging situation of having a loved one in intensive care by yourself, you’ll be fighting a losing and an uphill battle. Okay, that was number one, avoid a tracheostomy.
Let’s look at number two. Let’s just say a tracheostomy is unavoidable and let’s just say that is your only perceived option. Then you got to look at, how can you wean a tracheostomy? How can you wean a tracheostomy? How can you wean your loved one off the ventilator? Nine times out of 10, if a tracheostomy is needed in intensive care, it’s also needed because of your loved one can’t be weaned off the ventilator. So, let’s just say that is the case, then you need to get your loved one off the ventilator. And once that’s done, then you can look at a tracheostomy removal also known as a decannulation.
How can weaning off the ventilator happen? Well, it can happen through mobilization, through a weaning regime, through secretion management, through optimizing nutrition, stopping sedation, getting someone out of an induced coma. Those are some of the steps and some of the major steps that need to be taken to wean someone off the ventilator and then once they’re weaned off the ventilator, wean them off the tracheostomy.
How do you wean someone off the ventilator while you reduce their support? Ideally, you put them in a ventilation mode such as CPAP or pressure support ventilation. And then once that is achieved and arterial blood gases look good, chest X-rays look good, patient is being mobilized, sitting out of bed. Then you put them on the tracheostomy mask or tracheostomy hood, and you let them breathe spontaneously. They’re being disconnected from the ventilator, they have a tracheostomy mask sitting over the tip of the tracheostomy, they’re getting humidified air or humidified oxygen. Once you know your loved one can tolerate that for a few hours, sometimes even only a few minutes to begin with, you try to increase the time on the tracheostomy collar. And once someone can stay on the tracheostomy collar for up to 24 hours a day, well, they won’t need the ventilator anymore. So that’s how you wean. Again, I have made videos and written articles about, “How to wean someone off the ventilator and the tracheostomy?”
Next, there are different types of tracheostomies and for an adult, for example, adult size starts with a size six. Anything from a size, sort of, three to six is a pediatric size. Anything from six and above is an adult size. The biggest tracheostomy that I’ve probably seen is a size 10. Maybe I’ve seen a 10.5 at some point. Some of them come with an inner cannula and some of them don’t come with an inner cannula. And I’ll show you a tracheostomy now so you can actually see what I’m talking about. So, this is what a tracheostomy looks like and this is actually a size six, this is an adult size. So, you can see that. There’s a balloon there at the end that you inflate once you put the tracheostomy in. This cannula doesn’t have an inner cannula yet, but I will insert it in a second. So, you can actually see, this is an inner cannula, goes in there.
So, what is an inner cannula for? An inner cannula is basically almost like a safety mechanism for a tracheostomy. So, for patients that have a lot of secretions that need a lot of suctioning, it’s almost inevitable that they also have an inner cannula because you inspect that inner cannula four to six hourly. And if it’s soiled, you need to change it and you need to change it quite frequently because otherwise it might get blocked.
There are some patients that don’t get an inner cannula because they have minimal secretions and it’s okay for them not to have an inner cannula. But many patients have a lot of secretions and therefore they need a tracheostomy with an inner cannula. So, you can change it quite frequently and minimize the risk of a blockage. You can also see at the end of the tracheostomy that’s where you connect the ventilator. I’ll show you a little bit more, a bit later about how to inflate the balloon and so forth. Let’s just go through today’s topic a bit more.
And there’s also different brands. Most common brands that I’ve come across are Shiley, Portex, Bivona tracheostomies. Most of the balloons are inflated with air. Some of them are actually inflated with water as well. It’s mainly the Bivona tracheostomies that are inflated with water instead of air.
Now, I’ll just quickly show you what that looks when you inflate the balloon. So, I’ve got a 20 ml syringe here. You should ideally use a 10 ml syringe. I just don’t have a 10 ml syringe. So, you can see when you inflate the balloon. So that’s how the tracheostomy stays in position once it’s inflated and you can also check the pressure with a cuff manometer that I will show you at the end of the presentation.
Okay, so I’ve told you about different tracheostomies, is the same actually with pediatrics. So, pediatrics or children have sizes usually two to six. The increments in sizes is by 0.5. So, you have a 2.5, or 3, or 3.5. You also have 0.5 sizes for adults. So, you have a 6.5, a 7.5, 8.5 and so forth. For pediatrics, they come without a balloon. The tracheostomies are sealed without a balloon for kids because the airway is so narrow for children because it’s still evolving, and you need to upgrade sizes as children grow. But the principle is the same with the difference of that there are no inner cannulas for children and that the sizes are simply smaller.
Some of tracheostomies also have what’s called a subglottic port. What a subglottic port means, there is a port that goes below the balloon. And what a subglottic port enables you to do is do a subglottic suction. Basically, you can remove the secretions that are sitting right below the balloon to prevent aspiration. Okay, so that was number three and number four. I talked about different tracheostomies. I also talked about tracheostomies for children.
I also want to talk about another very important topic and that’s mobilization. You might think, what does mobilization have to do with tracheostomies? Well, I can tell you it has everything to do with tracheostomies. We have so many families in intensive care coming to us. They’re saying, “Oh, well…” One of the first questions that I have for them is, “Well, has your loved one being mobilized?” And they’re saying, “No,” and I go like, “Well, you can’t wean someone off the ventilator and the tracheostomy if you are not mobilizing your loved one.”
Mobilization, weaning off the ventilator, weaning off a tracheostomy, it goes hand in hand. One can’t work with the other. And if ICUs are telling you they can’t mobilize your patient, your loved one, that’s simply complacent and lazy. Now, there are exceptions to the rule. There are patients that can’t be mobilized but that’s predominantly when they have fractures. They might have a fractured leg, fractured arm, they might have a traumatic brain injury. Those are clear contraindications to mobilization, no question. But if none of this is present, mobilization is key for anyone in intensive care. It prevents pneumonia, it helps them managing their deconditioned position. A lot of patients in intensive care if they are in prolonged induced comas are deconditioned. And again, you can only wean off the ventilator, have the tracheostomy removed eventually if you’re getting mobilized regularly, starting physical therapy. Can’t stress this enough that this is absolutely critical.
Let’s move along to number six. So, what you need to know in ICU is you can wean off the ventilator, but the tracheostomy might still be needed. And I’ve seen this countless times and if you can’t wean off the ventilator, then the tracheostomy is still needed as well. So, let’s break this down into the first scenario.
If your loved one has been liberated from the ventilator but still needs the tracheostomy, what should happen next? Well, what should happen next is then ideally have the tracheostomy removed as well. And what should happen to remove a tracheostomy? Well, number one, there needs to be a good, strong cough present. There needs to be a spontaneous, good, strong cough. The cough needs to be so strong that they can clear their own secretions, they can clear their own airway. So, imagine the tracheostomy is an artificial airway, it’s an unstable airway. So, once you remove the tracheostomy, there needs to be a stable airway and you can only maintain a stable airway if strong coughing is present so that secretions can be mobilized. Otherwise, the tracheostomy needs to go back in because the airway will block without a tracheostomy.
So, what else needs to happen? Your loved one should ideally be able to talk. Your loved one should ideally be able to swallow. If they can’t swallow, the tracheostomy with a balloon needs to stay in because there is an aspiration risk. If your loved one can’t swallow for whatever reason, the tracheostomy needs to stay in because of the aspiration risk because they might swallow their own saliva or food if they can eat, into the lungs and that could cause an aspiration pneumonia, would be a massive setback. And your loved one would end up with pneumonia possibly ending up on the ventilator again. You certainly don’t want that.
Also, I said that your loved one should be able to talk. I’ll also quickly show you a speaking valve because the speaking valve is necessary for talking in with a tracheostomy. This is what a speaking valve looks like and it’s sitting on the edge of the tracheostomy. The guidewire needs to be out of course. The guidewire is just there when you insert the tracheostomy, so the tracheostomy doesn’t kink when you insert it. Then you attach the speaking valve, and the balloon needs to be down for speaking. You can’t talk with the balloon up. So that is the situation with speaking valves and when the tracheostomy can be removed, that is the ideal scenario.
So, if your loved one is weaned off the ventilator, has the tracheostomy removed in intensive care, and then they should be able to go to a hospital ward or a hospital floor and get on with their recovery.
Now let’s just say your loved one can’t be weaned off the ventilator, can’t be weaned off the tracheostomy or maybe has been weaned off the ventilator but still needs the tracheostomy. What’s next? Well, thank God there are solutions in 2022 for that. Your loved one should be good going home and that’s where our service Intensive Care at Home is coming in.
So, with Intensive Care at Home, we are offering home care solutions for predominantly long-term ventilated adults and children with tracheostomies or with mechanical ventilation or with a combination of both. So, tracheostomy ventilation management at home instead of intensive care as a genuine alternative to a long-term stay in intensive care. And you can find out more information at intensivecareathome.com but I will tell you more about it now. So, then you can look at a transition home.
Now one of your first questions might be, well, how does it all work? Who’s paying for it? How do you set it up? Let me explain to you. So, first things first, when you go home you need a team with a ventilator and a tracheostomy or only with a tracheostomy. You need a team of 24/7 intensive care nurses to make that happen because otherwise it’s unsafe. It could cost the life and I will talk more about that in a moment.
Funding? I wouldn’t worry too much about funding. An intensive care bed in 2022 costs around $6,000 per bed day whether that’s here in Australia, Australian dollars. Whether it’s in the U.S., U.S. dollars, it’s around $6,000 per bed day and Intensive Care at Home is around half of the cost. So that means it’s a win-win situation. ICUs are saving half of the cost but more importantly, they free up an ICU bed that is in high demand. Furthermore, you and your family can be at home. Well, I am saying that Intensive Care at Home is priceless. It’s priceless. Where would you rather be? Where would you rather be? I think the answer is obvious that you’d rather be at home than in ICU if the service can be provided at home with 24/7 intensive care nurses.
And the services are provided with or around the mechanical home ventilation guidelines. Now why is that important? Well, similar to intensive care we operate in a framework, and we operate in an evidence-based framework. Well, there’s evidence after 25 years of Intensive Care at Home services predominantly in Germany but also for the last 10 years in Australia, where Intensive Care at Home can only safely be provided for tracheostomy or mechanically ventilated patients with intensive care nurses, with a minimum of two years ICU experience. And that’s the core of our service, that’s what we provide you with. If you are in need of Intensive Care at Home services, that’s how we provide services. It’s very safe and it’s evidence-based. And that’s how ICUs can also relax that the patients don’t go back to ICU if the service is set up properly, 24 hours a day, to replace an intensive care bed in the community instead of in intensive care.
Okay. Next, what does tracheostomy management look like at home? Well, it looks fairly similar to tracheostomy management in a hospital, just that it’s done at home. You need all the emergency equipment. If your loved one has a size eight tracheostomy at home, you need a size eight spare tracheostomy for backup. But you also need a size lower, size seven in case you can’t get, say, size eight back. In case of an emergency, you need a size lower. You need a resus bag and Ambu bag.
You need a tracheostomy dilator. You need inner cannulas. You need nebulizers to keep the tracheostomy patent and to moisturize and humidify the lungs and the tracheostomy because the nose is bypassed. When you’re breathing through the nose, it automatically gets humidified keeping your lungs moist so that you can lose enough secretions. When you’re breathing in through the tracheostomy that is not the case because the nose is bypassed. And if you’re not getting the air or the oxygen humidified, secretions dry up, airways could block tracheostomies and that could be leading to a medical emergency or even worse a patient could die. So, you got to know what you’re doing.
You need to have a suction machine similar to ICU. You probably need to have a little bit of oxygen at home, oxygen concentrator, oxygen cylinder. If your loved one is still on a ventilator, you need a ventilator for home care. We generally speaking recommend ResMed ventilators. Then you need dressings for tracheostomy, split gauze or split ALLEVYN dressing. You need a tracheostomy tape that you can put around someone’s neck so that you can keep the tracheostomy in place. Then you need a resuscitation bag in case you loved one can’t breathe. I’ll quickly show you what that looks like. So that’s what a resuscitation bag looks like. You can inflate air. You can connect the end to the tracheostomy.
Then you need a suction machine, you need suction catheters. This is what a suction catheter looks like. There are also closed suction systems that you only need to change once a week. It has the advantage that if you use a closed suction system and someone is ventilated, that you don’t lose the ventilation support, you can preoxygenate. There’s a number of advantages when you use a closed suction system at home.
So, I don’t have a dilator. I would’ve wanted to show you a tracheostomy dilator which I can’t show you at the moment, but it pretty much looks like a pair of scissors but not with sharp edges. It’s blunt edges that in case the tracheostomy collapses that you can open it, that is just for emergency management.
Helene, nice to see you again and you are saying, “What if the outer cannula gets dislodged (no longer fit tight), would be replaced with a larger cannula?” Yes, and that’s why it’s important that when you choose or select a tracheostomy, that you choose the right size. It’s very important. So, if you have the right size, it won’t leak but if you have a tracheostomy that’s too small, there will be leakage. You will see secretions coming out. If your loved one is on a ventilator, you will see a leakage from the ventilator, then you probably need to go one size up. Or if what can also happen is that the balloon is not inflated enough, that can also happen. So, there could be a number of reasons. The ICU or the nurse needs to check whether the cannula is simply just small or whether the balloon is not inflated strong enough or big enough.
Another option when there is sort of what you’re referring to as leakage. What could also happen is that the tracheostomy is not secured enough which means it might bumble around because the tapes are not tied enough. So, there could be a number of reasons. You need to troubleshoot and work out what is the reason for the leakage.
Again you’re saying Helene, “Mom was turned without support”. I can’t make a comment on that but if you believe that was the case, then it sounds like that was negligent.
Next, so a lot of families come to us when they first realize that their loved one needs a tracheostomy. One of the first questions they have is, can they go home eventually? And as I said, the answer is yes. With Intensive Care at Home, they definitely can go home and there’s absolutely no issue there. And a lot more is possible at home than you think there is. We had kids at home, they went back to kindergarten, to school, they were mobile, they could run around if they could walk. But their quality of life has improved big time because they could finally leave ICU because they now have the ICU nurse at home, 24 hours a day.
Next, what else is possible at home for adults? We have adults at home that again they can go back to school, they can go back to university. We have decannulated some children at home. They had to have the tracheostomy for a few months. They were premature babies, they had to have the tracheostomy for a few months. And then after a few months, after their lungs had developed, we were able to decannulate them at home. So, a lot is possible at home with the right support.
It’s really important for you to understand what support is available and what is possible and don’t let the ICU discourage you. If they’re telling you can’t go home or you can’t be weaned, you got to do your own research and you got to talk to people who understand what’s happening outside of intensive care. Most health professionals in intensive care have no idea what’s possible outside of intensive care. And they’re living in their little bubble in intensive care and there’s a world out there and you got to look at that world out there. What is possible with a tracheostomy or with a ventilator at home?
Now the other thing that I quickly want to talk about is, as you probably gathered by now, if there’s an emergency in intensive care, you have a whole team of intensive care doctors, intensive care nurses coming to your rescue. Whereas at home you only have one nurse from Intensive Care at Home that can manage an emergency but again that’s why we work according to the home mechanical ventilation guidelines, which once again is evidence-based. And clearly says that you can look after ventilation tracheostomy at home with intensive care nurses, 24 hours a day, that have a minimum of two years intensive care nursing experience. And again, that’s the core of our service, that’s what we are accredited against.
So, in order to manage, God forbid, emergencies at home, if you don’t have the 24-hour intensive care nurse, you’re running risk of medical emergencies to happen. You’re running risk of potentially deadly situations and unfortunately, I’m not exaggerating here. We have firsthand experience where we looked after clients at home but that were only funded for overnight ICU nurses. And when we left in the morning, we knew those clients were at high risks of medical emergencies and so forth. And unfortunately, even though we made an appeal early on to the funding bodies, the daytime funding was denied for no good reason. And therefore, some of those patients died during the daytime when we weren’t there because family members or support workers simply couldn’t handle medical emergencies. That’s how serious this is. That’s why we go back to the mechanical home ventilation guidelines. They’re published on our website, intensivecareathome.com. You can read them and they’re evidence-based and you can only provide services at home that are safe with ICU nurses, 24 hours a day, that have a minimum of two years ICU or pediatric ICU nursing experience.
Again, what else do you need at home to keep things safe? So, I talked about the resuscitation bag, I talked about oxygen, I talked about spare tracheostomies. If you have a size eight, you need a spare size eight. You need a spare size seven, one size down in case you can’t get the size eight back in. You need a syringe to inflate the balloon. There are some tracheostomies that don’t have a cuff or don’t have a balloon. Most of the patients that have a tracheostomy that don’t need a balloon are not ventilated. That’s the exception to the rule. But most patients with an uncuffed tracheostomy don’t need a ventilator.
You need a nebulizer machine. Most patients need to have normal saline nebulizers four, or five, six times a day to keep the tracheostomy moist, patent, keep the lungs moist so that secretions can be mobilized. Ideally, you need a humidifier. If you’re ventilated, you definitely need a humidifier. If you’re not ventilated, you still should have a humidifier to have 37 degrees humidification going in. It’s also much nicer for a patient to have humidification so the secretions are not drying up. Especially when it’s cold outside, it’s much nicer to have warm air or warm oxygen going in.
In case you’re mobile and you don’t have humidifier, you can’t take a humidifier with you, you can use an HME filter attached to the tip of the tracheostomy. Sits right there and it’s also known as a Swedish nose. HME filter also known as a Swedish nose. I don’t have one here otherwise I would’ve shown you. But if you Google HME filter tracheostomy or if you Google Swedish nose tracheostomy, you will find a picture on Google.
You will need a suction machine, you will need suction catheters, you will need inner cannulas if your loved one has tracheostomy with an inner cannula.
You will also need, and I’ll show you that before I answer your question Helene, you will also need a cuff manometer. I’ll show you what to do with that. So, once you’ve inserted a tracheostomy and you’ve inflated the balloon with about five to seven mls, you can see the balloon going up. We’ll take the syringe off and now you can see the balloon blown up, but you also need to check the pressure. So now you can see, it’s actually far too high. You can see the pressure gauge it’s sitting around 80 centimeter of water and the needle needs to sit where the green section is. So now, I need to deflate some air. There’s a button there, the red button. I’ll press that button so air can go out and you can see the balloon is slowly going down while the needle is going down. And now we are where we want to be, 20 to 30 centimeter of water. Why is that important? If you blow it up too far, you can simply cause some airway damage and you can simply cause a pressure sore, you don’t want that.
Now, Helene, I know you had another question, just give me a second. “Should a rubber band be placed to keep the ventilator tube attached to the outer cannula? I found no rubber band was used for mom that resulted in the tube detachments meaning mom was not getting ventilation”. No, there’s no rubber band. “To keep ventilator tube attached to the outer cannula.” It’s not a rubber band. It’s like a like tape this that needs to secure the tracheostomy around the neck but that’s it. The ventilator should be attached to the end of the tracheostomy, that’s all. No band needed, just needs to be connected properly. But the tracheostomy needs to be in place around the neck, held in place by a tape like this.
Then, “what causes a patient to lose their ability to speak?” Yep, great question. So, you can see when the balloon is going up, Helene, like this, the vocal cords are paralyzed. Once the balloon is down, the ability to speak should come back but it doesn’t always come back straight away. That’s when you need a speech therapist, a speaking valve. Some patients can speak straight away after they have the balloon deflated, others can’t. A speech therapist often needs to do training. I hope that answers your questions, Helene.
I think that is all that I had for today. I wanted to make this as brief as possible.
If you have a loved one in intensive care, you should go to intensivecarehotline.com and to Intensive Care at Home. If you need home care services, go to intensivecareathome.com and on both websites you will find phone numbers to call you on, on the top of the website, just call us. You can also send us an email to [email protected].
Send us an email to [email protected].
If you like this video, give it a thumbs up, give it a like, share this video with your friends and families. I believe there is plenty of value in today’s video. Click the notification bell, subscribe to my YouTube channel for families in intensive care.
Now, I will do another YouTube live next week around the same time, 8:30 PM Eastern Standard Time in the U.S., 10:30 AM Sydney, Melbourne time in Australia. It’ll be 5:00 PM on Saturday, Pacific Time in L.A. and 8:30 PM Eastern Time is on a Saturday night.
Now, I also do one-on-one consulting and advocacy for families in intensive care. I do offer a 15-minute free consultation session and I do have paid consultations beyond the free 15 minutes.
We also have a membership for families in intensive care. You can find that at intensivecaresupport.org. That is again membership for families in intensive care at intensivecaresupport.org.
And if you need a medical record review for your loved one in intensive care, we offer that as part of our service as well. We can review your medical records or your loved one’s medical records daily. In this day and age most ICUs can just give you access to medical records online with a username and a password. Most ICUs have live medical records nowadays and that’s how we can help you very, very quickly.
Part of our consulting and advocacy services is also talking to doctors and nurses directly, participating in any family meetings you might have with them over the phone, and really diving deep when you have a loved one in intensive care, helping you to ask the right questions.
So, I want to close off today’s livestream. I want to thank you for watching this video. Thank you for your support and I will talk to you again next week around the same time.
Have a wonderful weekend and a wonderful Sunday. I wish you and your families all the very best.
Take care.
Now, if you have a loved one in intensive care and you want to go home with our service intensive care at home and if you want to find out how to get funding for our service and how it all works, please contact us on one of the numbers on the top of our website, or send me an email to [email protected]. That’s Patrik, just with a K at the end.
Please also have a look at our case studies because there we highlight more about what we can do for clients, how clients can live at home with ventilation and tracheostomies and you can look at our case studies as well at our service section.
Intensive care at home Case studies
And if you are at home already and you need support for your critically ill loved one at home, and you have insufficient support or insufficient funding, please contact us as well. We can help you with all of that.
And if you are an intensive care nurse or a pediatric intensive care nurse with a minimum of two years, ICU or pediatric ICU experience, and you ideally have a critical care certificate, please contact us as well. Check out our career section on our website. We are currently hiring ICU and pediatric ICU nurses for clients in the Melbourne metropolitan area, Northern suburbs, Sunbury, Bendigo, Mornington Peninsula, Bittern, Patterson Lakes, Frankston area, South Gippsland, Drouin, Warragul, Trida, Trafalgar and Moe as well as Wollongong in New South Wales.
www.intensivecareathome.com/careers
So we are also an NDIS, TAC (Victoria) and DVA (Department of Veteran affairs) approved community service provider in Australia. Also have a look at our range of full service provisions.
Thank you for watching this video and thank you for tuning into this week’s blog.
This is Patrik from Intensive Care at Home, and I’ll see you again next week in another update.