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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.
In last week’s blog, I talked about,
You can check out last week’s blog by clicking on the link below this video:
So in today’s blog post, I want to talk about,
Can Intensive Care at Home Train Family Members to Look After their Loved Ones on a Ventilator and a Tracheostomy?
This is a question we get very often from families that come to us that have a loved one in intensive care, or have a loved one at home on a ventilator with a tracheostomy, whether we can train them. They also asked that question if their loved ones only have a tracheostomy or are ventilated with BiPAP, CPAP and don’t have a tracheostomy. Now, the short answer to this question is a clear no, and I will evaluate on that.
So when someone is having a tracheostomy, is having a ventilator, it takes years of training to look after someone on a ventilator with the tracheostomy. It also takes years of training to look after someone with a tracheostomy.
Now, I would argue that 99% of patients with a tracheostomy when in hospital are in intensive care and in intensive care, doctors, nurses, etc., need to go through specialized training, to work in intensive care and that includes looking after ventilator, looking after tracheostomy.
The reason why someone is in intensive care, if they’re on a ventilator and a tracheostomy is simply that their life is in danger and that it takes those specialist skills to manage, maintain a ventilator/tracheostomy. The risk for a medical emergency is huge when someone has an artificial airway, because that is what a tracheostomy is.
Also if someone is ventilated without a tracheostomy and they’re on BiPAP or CPAP ventilation, they’re still on a mechanical ventilator and the reality is, that the risk that something goes wrong when someone is on a ventilator is fairly high. And therefore, people need to know what they’re doing.
The best analogy that I can make is, when someone is on a ventilator and a tracheostomy or both, if you’re not having intensive care nurses or intensive care doctors manage that, it’s like flying a plane with a cabin crew and not with a pilot.
So therefore we are unable to train families because you need to understand anatomy. You need to understand physiology. You need to have seen emergencies and how to successfully manage them. And unless you’ve done this numerous times, like we all have here at Intensive Care at Home where we employ hundreds of years of intensive care nursing experience. We just can’t pass on that intellectual property in a quick training session because as I mentioned, this takes years of experience.
I’ll give you some practical examples so you can understand why I’m saying what I’m saying. Number one, on our website at intensivecareathome.com, we have published the home mechanical ventilation guidelines. Now, if you look at the home mechanical ventilation guidelines, it clearly demands not suggests, it clearly demands that when someone is having a ventilator and/or a tracheostomy at home, they need to be intensive care nurses/critical care nurses, 24 hours a day full stop.
Now, those guidelines are a result of having performed intensive care at home services for the last 25 years, predominantly in German speaking countries but now also in Australia for the last seven years where we have certainly proven our concept here without a shadow of a doubt.
But to put this in even more practical terms, last year in 2020, we had three clients passed away within a very short period of time, just before Christmas in 2020.
Now, all three clients had a tracheostomy and/or were ventilated. Now all three clients only had limited intensive care nursing support at home. The clients were only funded for predominantly night shifts or were only funded for a few hours here and there.
Now, we have highlighted this from day one to the funding body that the clients are at risk of dying because there is no 24-hour care. We were making reference to the home mechanical ventilation guidelines. Again, this is evidence-based guidelines from the home mechanical ventilation guidelines at anybody on a ventilator and a tracheostomy needs to have intensive care nurses, 24 hours a day, full stop. And anywhere where this can’t be provided, clients are at risk of dying in a home care environment.
So we were only doing, we’re only funded for night shifts for those clients and all three clients within a very short period of time passed away during the daytime when no intensive care nurses were present.
Now, these were tragedies beyond my words here. The pain that the families have experienced and our experience here is huge but also the pain that we feel as a service provider, the pain, our nurses and myself have gone through by losing those clients, because two out of those three clients were children and it still breaks my heart to this day that those clients are no longer with us.
Two out of those three clients, especially the children were at their peak of their health since they were discharged from intensive care. And again, it is beyond my words to describe that those children in particular are no longer with us.
And whilst the NDIS scheme here in Australia has come a long way in terms of funding, nursing care for long-term intensive care patients so that they can go home, there are still gaps in the system, and those gaps in the system have cost some lives of some children that shouldn’t have been lost.
And that is the reason why we can’t train families because those families as well, were not in a position to manage those medical emergencies and that is the main reason why those clients are no longer with us.
So I hope that answers your question for today and let me know what questions that you have, and I can answer them here. Thank you.
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, Mornington Peninsula, Frankston area, South Gippsland, 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.
Also, we have been part of the Royal Melbourne health accelerator program in the past for innovative healthcare companies.
https://www.thermh.org.au/news/innovation-funding-announced-melbourne-health-accelerator
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.