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If you want to know if CPAP can be weaned at home with the tracheostomy, stay tuned! I’ve got news for you.

My name is 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. We also provide care to otherwise medically complex adults and children at home including Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure) ventilation, home tracheostomy care when adults and children are not ventilated, also Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care and ventilator weaning at home.

We’re also providing our critical care nurses to provide emergency department bypass services as we have done in the past for the Local Area Western Sydney Health District. We also avoid emergency department presentations by sending our critical care nurses into the home to change PEG (Percutaneous Endoscopic Gastrostomy) tubes, catheters, tracheostomy tubes, even do casts and also home X-rays with another organization. So, that’s just for information.

Today, I have an email from Stephanie who says,

“Hi, Patrik,

My dad has been in ICU for two months now. He isn’t weaning off CPAP with a tracheostomy. ICU says he’s not making enough progress to leave intensive care yet. Therefore, we want to bring him home, but we need to know who would be paying for a service like Intensive Care at Home.”

Well, Stephanie, thank you so much for reaching out and who will pay for a service like ours.

Well, first of all, if your dad is in ICU and he can’t be weaning off the CPAP, that means he’s already made some progress away from a controlled ventilation mode such as ACV (assist control ventilation) or SIMV (synchronized intermittent mandatory ventilation). He has already made some progress, so it sounds to me like he might be halfway there, but you haven’t shared enough information to really find out what needs to happen next to wean your dad off the ventilator.

Now, if ICU says it’s taking a lot longer and your dad is probably depressed in ICU, he has no quality of life whatsoever, and you and your family probably spend day and night in ICU to be with your dad. We can provide this much needed win-win situation which means we can provide your dad with quality of life at home. We can provide you and your family with quality of life at home, and we can free up the ICU bed that is in high demand. We can free up their staff, their resources, etc. Lastly, we can cut the cost of an intensive care bed by approximately 50%. ICU beds cost around $5,000 to $6,000 per bed day. It’s a win-win to reduce the cost by approximately 50%.

So, what does it look like at home? Well, your dad needs a ventilator, he needs suction machine, he needs monitors, he needs spare ventilator, he needs spare tracheostomies, emergency equipment for tracheostomy changes, inner cannulas, and nebulizer machine. He probably needs a hospital bed. He probably needs a lifting machine like a hoist machine or a Hoyer machine. But that’s all part of what we do, setting up the home care environment so it’s safe, so we can take our clients and their families home, improving their quality of life.

Now, in terms of weaning off CPAP, but what needs to happen there is, again, you haven’t shared any settings. So, let’s just say he’s on a PEEP of 5 and he’s on a pressure support of 12 and the tidal volumes (volumes that he’s breathing) are okay. Pressure support needs to be lowered, maybe to a point of ideally 8, then a spontaneous breathing trial can be started assuming PEEP isn’t changing and FiO2 (the oxygen that’s being given) is less than 40%. You haven’t mentioned anything about oxygen, but obviously, something’s not working, to wean your dad off the ventilator, maybe has a lot of secretions that he’s producing.

But from experience, a home care environment can make all the difference because it is just so much more conducive to be weaned at home than it is in an intensive care unit where it’s noisy, loud people are running around 24 hours a day. There’s emergencies happening.

Also, there’s a high risk of infection, that your dad will catch an infection in an intensive care environment because there are so many sick people around him. Doctors and nurses unfortunately carry the bugs with them when they go from patient to patient. Despite all, good infection control practices, washing hands, and changing aprons and all the rest of it. You have to keep in mind the exposure to other infections in an intensive care unit is just extremely high. So, that is all eliminated and diminished at home because you are in a much cleaner environment compared to an intensive care unit.

So, again, this is a win-win situation for everyone. It’s a win for you, for your dad. It’s a win for the health system. It’s a win for the ICU. It’s a win for whoever’s funding the ICU bed, and who’s going to fund it. Whoever’s paying for the ICU bed right now would have an interest in cutting the cost by 50%. Once again, it is all about creating win-win situations.

I’ll talk more about funding in a minute so you can have a better understanding on how our service is funded. Because with Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in regional and rural areas. We are a NDIS (National Disability Insurance Scheme) approved service provider all around Australia. We are a TAC (Transport Accident Commission) approved and WorkSafe approved service provider in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland, as well as DVA (Department of Veteran Affairs) approved service provider all around Australia. Our clients have also received funding through public hospitals, departments of health as well as private health funds, so reach out to us at intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to info@intensivecareathome.com.

Like I mentioned, we’re also sending our critical care nurses into the home or into residential aged care to keep emergency departments empty and avoid emergency department presentations. If you want that for your hospital or for your residential aged care facility or for your family member at home, please reach out to us as well. We have done this successfully for the Western Sydney Local Area Health District for the in-touch program to keep their emergency department empty and less crowded.

If you’re at home already and you have insufficient support for your loved one or for yourself, I also encourage you to reach out. We know a lot of clients on ventilation, tracheostomy at home with insufficient support and they’re going back to hospital all the time, or worse, they are at risk of dying. People have died at home on ventilation and/or tracheostomy because they didn’t have intensive care nurses, 24 hours a day, and they’re not improving their quality of life or they’re not having the right teams assembled around them that are reliable and actually know what they’re doing. We can definitely help you with that. They’re also of not having the right funding for their condition at home. Once again, we can help you with funding for critical care nurses at home. Otherwise, we would not be in business if we hadn’t successfully advocated for our clients.

We’re also providing Level 2 and Level 3 NDIS Support Coordination. If you want to know more about our Level 2 and Level 3 NDIS support coordinator, Amanda, I’ve actually also done an interview with Amanda, which I will link to below this video.

If you are a NDIS support coordinator from another organization and you’re looking for nursing care for your participants, please reach out to us as well. We are also providing NDIS specialist nursing assessments or we’re also providing nursing assessments for any other funding body or insurance that you need a NDIS nursing assessment for, especially when it comes to medical complexities, complex ventilated and tracheostomy clients in the community or in hospitals. If you are a NDIS support coordinator struggling with getting nursing care for your participants, please reach out to us as well. Once again, we have been successfully involved in the advocacy for our clients from Day 1.

If you are a critical care nurse and you’re looking for a career change, we want to hear from you as well. If you have worked in critical care for a minimum of two years and you ideally have completed a postgraduate critical care and nursing qualification, we want to hear from you. We currently have jobs in Melbourne, Sydney, Brisbane, Albury, Wodonga, Bendigo in Country Victoria, as well as in Warragul in Country Victoria. We want to hear from you.

Please keep in mind we are looking for critical care nurses that want to complement our team. We want to hire staff that give us regular availabilities because that is what our clients want. Everything that we do is driven by our clients. Our clients want regular staff. That’s why we can provide a tailor-made solution for our clients and their families, and that is what they want.

If you’re an intensive care specialist, we’re currently expanding our medical team as well. We want to hear from you if you’re interested in working with us.

If you’re an intensive care specialist and you have bed blocks in your ICU, I encourage you to eliminate your bed blocks because we can help you to do that. More importantly, we improve the quality of life and sometimes, quality of end of life for your patients and their families. You won’t pay for it, and you can free up your ICU bed.

If you’re a hospital executive watching this, we also want to hear from you because once again, we can help you eliminate bed blocks in ICU, emergency department, respiratory wards, etc.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to info@intensivecareathome.com.

If you’re in the U.S. or in the U.K. or in Canada, please reach out to us. We can help you there privately.

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, and share this video with your friends and families.

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Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.