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 otherwise medically complex Patients by improving their Quality of life and where we also provide tailor made solutions to hospitals and Intensive Care Units, reducing the cost of an ICU bed by 50%, whilst providing Quality Care!
In last week’s blog I talked about
You can check out last week’s episode by clicking on the link here.
In today’s blog I want to answer a question that we get quite frequently
Can a person be weaned off a ventilator and tracheostomy at home?
The answer to this question somewhat depends but in most cases Patients on long-term ventilation and tracheostomy can be weaned off it at home.
If you look at long-term ventilation and tracheostomy in Intensive Care and you look at the high average length of stay, the high cost, the burden for Patients and their families as well as the lack of quality of life for Patients and their families it should be a ‘no-brainer’ that Patients should be weaned off ventilation and tracheostomy at home instead of a sterile Intensive Care environment!
The average length of stay for long-term ventilated Patients in Intensive Care generally speaking is 50 days plus and not all Patients can be weaned off ventilation and tracheostomy.
The cost is enormous with $5,000 per bed day in Intensive Care and everybody knows that Intensive Care beds are in high demand and scarce!
Furthermore, the lack of quality of life for Patients and their families in Intensive Care is obvious!
This can be changed in an instant when Patients on ventilation with tracheostomy go home and get similar care with Intensive Care nurses coming into their home 24/7 and with the medical oversight of an Intensive care specialist or a group of intensive care specialists.
Most long-term ventilated adults & children with tracheostomies and their families are wanting to continue treatment at home wherever possible.
This just stresses the fact that the hospital environment is shifting towards a more holistic, Patient and family friendly environment that also provides a way more cost- effective solution compared to a $5,000 per bed day Intensive Care bed!
The evidence clearly suggests that going home from Intensive Care for weaning off ventilation and tracheostomy is possible when services are performed according to the MECHANICAL HOME VENTILATION GUIDELINES
You can read the MECHANICAL HOME VENTILATION GUIDELINES here
What’s the difference and what are the results?
This is a good question to ask and the evidence again suggests that once a Patient (adults & children) on ventilation with tracheostomy is medically stable and off inotropes/vasopressors there is no reason why they can’t be transferred home and continue treatment.
This requires 24/7 Intensive Care nursing and the oversight of an intensive care specialist for medical governance for ventilator weaning.
The results are similar to an Intensive Care environment as again is highlighted in the MECHANICAL HOME VENTILATION GUIDELINES here
Why would a long-term ventilated Patient (adults & children) with tracheostomy occupy a bed in Intensive Care for many weeks and many months if there is a more Patient and family friendly and also holistic solution that also reduces the cost of an Intensive Care bed by ~50%.
Patients and families report a much higher satisfaction rate at home compared to Intensive Care and they feel empowered and more in control!
Families are able to go back to some sort of “normality” when they can finally leave Intensive Care and go home.
With the commencement of a 24/7 nursing roster at home a frictionless transition home is possible.
Other steps when weaning from ventilation and tracheostomy at home are similar to intensive care and include
- Increasing the time off ventilation when on CPAP or pressure support ventilation
- Decrease respiratory rate when on SIMV ventilation and encourage spontaneous breathing
- Decrease PEEP and or pressure support
- Increase time on tracheostomy collar or tracheostomy shield/mask
- Check regular arterial or peripheral blood gases
- Monitor oxygen saturation and CO2 (carbon dioxide) levels
- Regular nebulisers such as Normal Saline and/or Atrovent/Ipratropium and Ventolin/Salbutamol if indicated
- Mobilisation and physiotherapy/physical therapy with a focus on strengthening breathing muscles
- Regular suctioning, bronchial toileting
Furthermore, if you are reading this and you are in the USA, you may wonder why your loved one should go to LTAC (long-term acute care) if they are in ICU ventilated with tracheostomy, if there is a home care solution that works much better for you and your family!
Intensive Home Care nursing can make this all possible for you and your loved one!
From a hospital and Intensive Care perspective, we can help you manage your ICU beds and help you facilitate your resources much more effectively.
Especially with the high demand on ICU beds and ICU’s often being bypassed due to the lack of resources (I.e. beds) we can help you free up some capacity and get your long-term ventilated Patients home!
What are you waiting for?
If you want to find out how we can help you to get your loved one out of Intensive Care including palliative care or Long-term acute care (also nursing home) or if you find that you have insufficient support for your loved one at home on a ventilator, if you want to know how to get funding for our service or if you have any questions please send me an email to [email protected] or call on one of the numbers below.
Australia/New Zealand +61 41 094 2230
USA/Canada +1 415-915-0090
UK/Ireland +44 118 324 3018
Also, check out our careers section here
We are currently hiring ICU/PICU nurses for clients in the Melbourne metropolitan area and in South Gippsland/Victoria.
We are 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 here
We have also been part of the Royal Melbourne health accelerator program for innovative health care companies last year!
Thank you for tuning into this week’s blog.
This is Patrik Hutzel from INTENSIVE CARE AT HOME and I see you again next week in another update!