Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults& Children with Tracheostomies by improving their Quality of life and where we also provide tailor made solutions to hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!
In the last blog I talked about
So in last week’s blog, I answered another question from one of our readers, Denise, who asked
You can go and check out last week’s question by clicking on the link here.
In today’s video blog, I want to answer another question from one of our readers, Ellen and Ellen sends an email and Ellen is in Melbourne, Australia.
Can my son go home from ICU with BIPAP ventilation and tracheostomy? He has ALS and he’s a CO2 retainer, help!
My son has a tracheostomy and is in ICU. He does well without ventilation support for 12 hours with carbon dioxide or CO2 in the range of 37 to 47.
My question is, can he be managed with BiPAP at home over night? My son is 36 and he has a history of retaining carbon dioxide, which has improved over time. My son was diagnosed with ALS about eight months ago. He walks with assistance with a cane and he has been in the hospital now for two months.
He went with low sodium, elevated CO2 up to 57 and elevated blood pressure. He was unmonitored for awhile and passed out, and he had to be intubated on three different occasions before he went into ICU long-term. Hence with the ventilation, he also got hospital acquired pneumonia with klebsiella and pseudomonas.
He got over it in the end. He had a tracheostomy about two months ago, and he’s doing well without a ventilator now for over 12 hours. The ICU feels he may need to stay in ICU for quite some time until he’s completely weaned off the machine. I, on the other hand, believe that home ventilation and intensive care at home is appropriate with BiPAP instead.
Please advise what your options are.
Thank you, Ellen, for sending this email and clarifying your son’s situation. It’s what the ICU is telling you is very old fashioned and it’s sort of, they’re stuck in what they’ve been doing for decades and it’s clearly not working. Of course, your son can go home and should go home with intensive care at home nursing rather than staying in ICU for the next few months until he supposedly comes off the ventilator.
Now with ALS, I think there’s a high chance your son may need ventilation for quite some time to come as it’s usually a progressive disease.
Can BiPAP be done at home overnight? Absolutely, yes. We could also monitor his CO2 either with a monitor or even with blood gases that we could take from the ear.
So there’s a number of ways to manage your son at home safely, either with just overnight nursing care, but I believe your son will need 24 hour nursing care because if he’s stuck in ICU 24 hours a day, he will need ICU and intensive care at home 24 hours a day and we can provide that for you.
So, the BiPAP will most likely get his CO2 down because that’s what BiPAP usually does. And now that it’s 37 to 47. It’s not too bad, but you know, usually below 38 is better consistently.
So here is where our model of care fits in really in this with the ICU as well. You know, your son can’t go to a hospital ward because the hospital wards can’t look after ventilation and tracheostomy.
So the only really option for your son to be weaned off the ventilator safely instead of an ICU is at home. We’re sending ICU nurses into the home 24 hours a day. So we’re basically providing an intensive care substitution service that has a lot of advantages for the hospital and the ICU as well.
An ICU bed costs around five to $6,000 per bed day, and we are slashing that cost to about 50%. Hence, the hospital and the ICU have an interest to get your son home as well. Now that improves his quality of life, of course. It improves your quality of life because you don’t have to spend 24 hours a day in ICU. You can spend 24 hours a day at home with your son. And I’m sure there’s other family involved as well.
So it’s a win-win situation, right? And now with the NDIS coming in, the National Disability Insurance Scheme funding nursing care, it’s much easier to obtain funding as well. And again, it’s a win-win situation because we’re slashing the cost of an ICU bed by 50% and furthermore, ICU beds are in high demand and the ICU needs the beds.
So I think the next step really is go and call me on one of the numbers on the top of the website, or send me another email to [email protected].
Now, given that your son is only 36, is also a good chance that once he’s at home, maybe he can do some work from home. Though you don’t know what your son was doing beforehand, but you know, if he can use a computer, for example, there’s also a chance that he might be able to produce an income again. We have seen all sorts of positive things with our clients happening once they’re at home.
You know, that you can’t beat home. And ICU’s can’t offer what we can offer at home. And then in terms of weaning, yes, some might be able to be weaned and we can achieve that if his condition allows.
So that’s my tip and my question for today. If you need help, if you have a loved one in ICU or in pediatric ICU or if you’re at home already and you want to get more support because your loved one might go back to ICU all the time, cause you don’t have ICU nurses at home, please again, give us a call on one of the numbers on the top of the website or send me an email to [email protected], that’s Patrik just with a K at the end.
Also, if you’re an ICU nurse or a pediatric ICU nurse with a minimum of two years ICU experience, please go and check out our career section. We are currently hiring ICU nurses and pediatric ICU nurses in the Melbourne metropolitan area, on the Mornington Peninsula, in the Warragul area, also in Sunbury.
So we have vacancies for highly motivated and highly confident ICU/PICU nurses with a minimum of two years ICU or pediatric ICU experience, and ideally with a critical care certificate as well.
Thank you for watching this video. This is Patrik Hutzel from intensive care at home. And I’ll see you in the next video. Take care.