Cerebral Palsy in ICU: BIPAP (Bi-level Positive Airway Pressure), Tracheostomy, and Evidence-Based Home Care with 24-Hour Intensive Care Nurses with Intensive Care at Home

So, I want to welcome you to another YouTube live stream from intensivecarehotline.com and intensivecareathome.com.

My name is Patrik Hutzel, critical care nurse and founder of both services, intensivecareathome.com and intensivecarehotline.com, where we help families of critically ill patients in intensive care to make informed decisions, get peace of mind, control, power, and influence, making sure your loved ones always get best care and treatment.

And obviously, with Intensive Care at Home, we are providing services at home, predominantly for long-term ventilated adults and children with tracheostomies, but also for adults and children on BIPAP (Bi-level Positive Airway Pressure) and CPAP without tracheostomy, tracheostomy care without ventilation, cough assist management at home, ventilation weaning management at home, home TPN, home IV potassium, home IV magnesium, home IV antibiotic infusions, PICC line, central line, Hickman’s line, port management at home, nasogastric tube, nasojejunal tube, PEG Tube (Percutaneous Endoscopic Gastrostomy) management at home, as well as palliative care services at home

So, today, we’ll be discussing cerebral palsy in intensive care, as well as the discharge process to Intensive Care at Home, which is often what is needed to not only keep cerebral palsy clients alive and also give them quality of life or  in some instances, quality of end of life. Today, we discuss about what you need to know if your loved one is critically ill in ICU, how we can help you there, but also how we can help you to take your loved one home safely with 24-hour intensive care nurses.

Now, before we dive into the subject, I’ve worked in critical care nursing for over 25 years in three different countries, where I worked as a nurse manager for over five years in intensive care. I’ve been consulting and advocating for families in intensive care here at intensivecarehotline.com since 2013. And we’ve been consulting and advocating for families in intensive care all over the world. I’m also the founder and managing director of Intensive Care at Home. And with Intensive Care at Home, we’re sending our critical care nurses into the home 24 hours a day. With Intensive Care at Home, we are currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas.

We’re also providing level 2 and level 3 NDIS support coordination, as well as TAC and WorkSafe case management.

Today, we’ll be spending the first 30 minutes focusing on cerebral palsy in hospitals and ICUs, and then we’ll move to how Intensive Care at Home provides evidence-based high-quality care at home, including BIPAP, tracheostomy, seizure management, all delivered by 24/7 critical care registered nurses at home with Intensive Care at Home.

Also, I want to welcome our viewers on replay. I know a lot of people can’t make it to the live, but they watch this on replay. So, I want to acknowledge your attendance here as well. If you are here live, type your questions into the chat pad or connect with me live here on the Stream Yard link by clicking on the Stream Yard link. I’m posting the Stream Yard link into the chat pad. Also, if you like my videos, subscribe to my YouTube channel, click the Like button, click the notification bell, comment below so that I can make the content that you want me to make.

So, let’s go to the first segment and let’s look at understanding cerebral palsy and ICU admissions. Cerebral palsy, also known as CP, is a neurological condition that affects movement, muscle tone, and coordination. Many children and adults with CP eventually end up in ICU due to respiratory failure, pneumonia, aspiration, or a seizure, or a combination of all of it. And I’ve seen it over and over and over again, not only since I’ve worked in ICU and looked after thousands of critically ill patients and their families but also in home care with Intensive Care at Home

And by the way, I’ve been working with Intensive Care at Home in two different countries. Not only was I part of launching Intensive Care at Home in Germany, I also launched it here in Australia since 2012. So, I can talk about decades-long experience with intensive care, in ICU, but also with decades’ worth of Intensive Care at Home experience. So, to combine both worlds, you need to understand both worlds inside out.

And I do believe I have the ability to understand both worlds inside out. So to combine both worlds and make sure that our clients get what they need, whether it’s in intensive care, when we consult and advocate, when we review medical records, or whether it’s at home, when it comes to setting up Intensive Care at Home, when it comes to the funding, when it comes to creating a team at home, because that is critically important, the selection of the right team.

So, when cerebral palsy patients go into ICU, when that happens, they often need BIPAP ventilation, CPAP ventilation. Sometimes they need intubation and mechanical ventilation, which could easily lead to a tracheostomy. Unfortunately, families are often told that the ICU is the only option, but that is certainly not true. And that’s what we will be talking about today. Another treatment form, especially when it comes to respiratory issues with cerebral palsy clients, is obviously the AIRVO high-flow nasal cannula or high-flow nasal prongs. That’s also a more and more common treatment option when it comes to cerebral palsy and the respiratory issues that, unfortunately, go hand in hand with it.

So, when an adult or a child goes into ICU with cerebral palsy, as we all know, ICUs are designed for short-term stabilization, certainly not for long-term quality of life. Adults and children with cerebral palsy are often much safer and better off at home with 24/7 specialized ICU nurses. And I’ll explain that, obviously, as we go along today in this live stream.

So, in many ICUs, patients with cerebral palsy are placed on BIPAP or CPAP ventilation to begin with for respiratory support. Some eventually need a tracheostomy if long-term ventilation becomes necessary, if BIPAP or CPAP are no longer working because of, let’s just say, aspiration risk. And many cerebral palsy clients, especially when they were born with the condition, also have a fundoplication, which minimizes, if not excludes, aspiration risk. And that might be one way to prevent a tracheostomy. It’s not the only way. But sometimes a tracheostomy is necessary because patients also can’t keep their airways open for a number of reasons. So, when long-term ventilation becomes necessary, then a tracheostomy becomes necessary. Now, some ICUs might flat out tell you that a tracheostomy will not be in your loved one’s “best interest” and that it’s actually “in their best interest” to stop treatment and let them die.

Well, nothing could be further from the truth. I would want you to talk to some of our clients that have been living at home with cerebral palsy for years with the right level of support. They want to live. They have community access. They live with family. It’s the right environment for the right patient. And that’s what ICUs don’t know. They just have such a limited point of view most of the time. They do not understand the leverage points between ICU and Intensive Care at Home. They do not understand that stable teams, for example, in the community that we provide makes all the difference. Because in ICU, you’ve got people coming and going, whether it’s doctors or nurses. And when families come to us, they’re very frustrated by that. But they’re not telling ICUs that because they don’t want to upset the ICUs.

But the bottom line is, that’s the reality of an ICU. Nobody wants to look after the “long-term patient” because they’re often being seen as a nuisance. Whereas we don’t see our clients or our patients as a nuisance. We see them as a client or as a customer. We want to engage with them. We want to work with them. We want to help them. They are what we specialize in. Come to us. We believe we understand you. We understand your needs.

We understand your need to be understood. We understand your need that you’ve been traumatized by hospitals. We understand your need that you need to be able to engage with people in a safe environment. And I know that you don’t perceive ICU as a safe environment because the doctors and the nurses might make you feel as if they’re judging you because of the choices that you have made for your loved one. And you are well within your rights to make those choices for your loved one.

So, let’s come back to the clinical. Obviously, managing BIPAP or tracheostomy for a patient with cerebral palsy requires 24/7 critical care nurses, definitely not general nurses, or let alone support workers or carers. That would be a death sentence. And I’ll come to that in more detail as we go along, that when general registered nurses or carers, support workers are looking after cerebral palsy, BIPAP, CPAP, tracheostomy in the community, people have died because of it. But I will come to that later.

So, why is that? Why do they need to go into ICU? And if they go home, why do they need Intensive Care at Home? Because, as you would well know, the patients can desaturate, have airway blockages, or seizure-related respiratory arrests at any time. Only an ICU-trained nurse can handle these emergencies safely. Unfortunately, many hospitals try to wean too early or not at all, discharge too soon, or try and push families towards palliative care instead of offering ongoing treatment and long-term home ventilation options, either on BIPAP or on CPAP or with a tracheostomy. And that’s where exactly intensivecareathome.com steps in.

You also need to understand that not only with 24-hour nursing at home, but also with the right medical cover at home, with an intensive care specialist or respiratory physician, pretty much the ICU can be brought home very safely so that patients can be at home predictably.

Next, seizure management in ICU. Seizures are quite common in patients with cerebral palsy and are a regular occurrence and are one of the main reasons for ICU admissions. Seizure management in ICU requires constant observation, airway management, and sometimes ventilation support. Now, imagine how overwhelming this is for families watching their loved ones sedated, intubated, and surrounded by alarms and by the negativity of ICU teams.

But here’s the good news: seizure management and ventilation, invasive, BIPAP, CPAP, or non-invasive with a tracheostomy, or non-invasive on BIPAP or on CPAP, can be safely done at home with 24/7 ICU nurses who are trained to recognize and respond to seizure activity immediately, preventing unnecessary ICU admission.

So, again, this is where evidence-based care at home comes in. Hospitals are all about evidence-based care. Well, it’s the same for us. So, we provide services at home according to the evidence-based Mechanical Home Ventilation Guidelines. And I encourage you to go to our website at intensivecareathome.com and have a look at the Mechanical Home Ventilation Guidelines, because they’re evidence-based. And they clearly say that exclusively critical care nurses with a minimum of two years’ critical care nursing experience can safely provide care at home for ventilation, tracheostomy, whether it’s invasive or non-invasive ventilation. But even if it’s tracheostomy only, without ventilation, even then a critical care nurse is needed 24 hours a day for tracheostomy patient with cerebral palsy.

So important that we always stick to the evidence. If support workers at home would be evidence-based, well, I’ve yet to wait for a research paper to say that, because that is like flying the airplane with a cabin crew instead of the pilot. Again, it’s like flying the airplane with a cabin crew instead of the pilot. We know how that would end. And again, I will talk more about, unfortunately, patient deaths later in the community because they were looked after on ventilation, tracheostomy, BIPAP, CPAP, with support workers instead of intensive care nurses, and that patients have died.

So, before we move into home care discussions, it’s important to understand that ICU is not a place for long-term care. Prolonged ICU stays increase the risk of hospital-acquired infections, pressure injuries, deconditioning, delirium, ICU psychosis, emotional trauma and mental trauma for patients and for families. At home, infection risk is much lower, and patients enjoy privacy, comfort, and dignity.

Like I said, I believe we have created a safe environment for our clients to not feel judged about whatever they’ve experienced in ICU because most families that come from ICU are extremely traumatized, but they’re not sharing that with the ICU because they don’t want to feel judged. They don’t want to jeopardize the relationship that they’ve got with the ICU.

And let’s now talk about how Intensive Care at Home makes a transition from ICU possible, safely, effectively, and for any funding body, most cost-effectively as well. And the other thing that I’ve learned over the years is, when I talk to clients directly that are at home already, every time I’m talking to clients, it’s almost this begging where they’re saying, “We never want to go back to ICU ever again.” And who can blame them? Who can blame them? Who can blame our clients for wanting to be at home?

So, let’s now look at Intensive Care at Home for cerebral palsy at home. And before we go into the deep dive there, also let me say when patients have, or cerebral palsy patients in particular, have seizures, uncontrolled seizures, grand mal seizures, tonic-clonic seizures, sometimes even absence seizures, it needs a seizure management plan. And those seizure management plans, I can tell you, usually include giving of benzodiazepines like diazepam or midazolam, also known as Versed if you’re watching this from the U.S. Midazolam is called Versed in the U.S.

Now, with that comes a high level of skill that is needed to manage grand mal, tonic-clonic seizures, also to prevent them. But as soon as there’s benzodiazepines involved, such as diazepam or midazolam, sometimes there’s opiates involved, such as fentanyl or morphine, in seizure management plans, it needs a critical care nurse because those medications, diazepam, midazolam, fentanyl, morphine, are most of the time given in ICU, and it’s the same at home, at such doses that patients can stop breathing because of those doses needed. And if someone stops breathing, you need a nurse there that can manage an unstable airway because that’s what it is. If someone stops breathing, that’s considered an unstable airway.

Once again, with intensivecareathome.com, we operate under evidence-based Mechanical Home Ventilation Guidelines, which you can find on our website. Also, we are the only service provider in Australia in 2025 that has actually achieved third-party accreditation for Intensive Care at Home nursing. There’s no other service provider in the country that has the policies, procedures, and the intellectual property that we’ve built over the years for Intensive Care at Home.

So, our guidelines and policies and procedures are built on best practice standards for home ventilation with tracheostomy, BIPAP, CPAP, and seizure management. Our Intensive Care at Home model has been proven safe, effective, cost-effective as well, and life-changing for patients with cerebral palsy who are ventilated and or tracheostomized. In fact, it’s the same level of care as ICU, but delivered in the comfort and safety of your own home. So, keep that in mind that we can do at home in comparison to what you are getting right now in ICU.

Also, we have medical cover. Some of it depends a little bit on the location. But most of the time, we can provide medical cover as well, which is, obviously, necessary. But sometimes we’re also happy to work with a discharging hospital, of course, to get medical cover. You can bring your own medical cover if you like, if you have the ability to do so. I know that if you’re watching this, you have already thought outside of the box, so to speak. I know you have thought already what you can do for your family member to go home if you’re stuck in ICU.

So, again, our model has been proven to be safe, effective, and life-changing for patients with cerebral palsy who are ventilated and/or tracheostomized. In fact, it’s the same level of ICU care, but delivered in the comfort and safety of your own home. Again, keep in mind, there’s also much less infection risk at home. So in an ICU, there’s a super high infection risk simply because there’s so many other patients in ICU that are infectious. You might not be in close contact with another patient, but the reality also is that doctors and nurses going and physiotherapists and OTs (occupational therapists) and even support people in ICU, such as ward support or orderlies, when they go from patient to patient and they’re not washing their hands properly and they’re not changing aprons, for example, the reality is that your loved one will be at much higher risk of infections than at home, because you’re not surrounded by sick people at home.

Also, another big aspect for home care is, that’s not talked about as much because ICUs are so far removed from the reality of Intensive Care at Home, you can have your pets at home. Now, tell me, for anyone watching this that has had a family member in ICU or has been in ICU themselves, maybe not necessarily long-term, but you have pets at home. Now, you can’t tell me you’re not missing your pets, let alone you’re missing your family members, of course. But pets are actually therapeutic, whether it’s the cat or the dog at home or both, they are very therapeutic. Whilst I understand that there’s different, again, infection control standards in ICU than there are at home, maybe bringing a cat or a dog into ICU every now and then will help with recovery. Your pets are very affectionate. We know that, and they can help with healing. They can also help with healing trauma.

So, now let’s look at the role of 24/7 critical care nurses at home. This is pretty much the foundation of what we do with Intensive Care at Home, 24/7 intensive care nurses providing care at home for patients with cerebral palsy on BIPAP or CPAP ventilation with or without tracheostomy.

Now, some of our cerebral palsy clients at home are ventilated with a tracheostomy on SIMV (Synchronized Intermittent Mandatory Ventilation), for example, or on ACV (Assist-Control Ventilation). We talk about regular seizure management, also talk about PEG feeding, suction requirements, giving nebulizers, using high flow nasal prongs or the Airvo when needed, which is basically humidified air or humidified oxygen, using cough assist when needed and if needed. Be prepared for, in the unlikely event of an emergency, suctioning, tracheostomy blockage, and so forth.

Only critical care nurses have the skill set to maintain airway safety, manage ventilators, respond to emergencies, change tracheostomies at home, and prevent ICU readmissions. We’ve had many clients successfully discharged home from ICU with cerebral palsy, but of course, also with other conditions, manage ventilators, manage tracheostomies, respond to emergencies, and prevent ICU readmissions.

We’ve had many clients successfully discharged home from ICU and living safely with their families, sometimes for years, with quality of life restored, with community access, surrounded by their families. Some of our clients even go back to work if they have a job that they can work from home or work with a computer, some even with an Eyegaze computer.

So, whenever ICU is talking about there’s no quality of life or when they’re talking about a “meaningful recovery,” well, what’s meaningful is up to you, not to ICU. Because you can now glimpse into the other world how we provide Intensive Care at Home, which is what many ICUs may know in theory but have no idea about our clients’ life at home in practise. Now, some ICUs, depending on where you are, they have staff working in ICU that also work for us. They are perfect to bridge that gap.

Let’s look at safety, quality of life, and again, let’s look at reduced infections. Again, when we talk about safety, there’s a few aspects here that I’d like to mention. Number one, we have by now provided millions of hours of Intensive Care at Home. We’ve been in business now since 2012. Some well-meaning people told me at the time, “Well, don’t waste your time. Nobody will ever pay for this.” Well, I believed otherwise.

I obviously believe in Intensive Care at Home wholeheartedly. It’s a concept that I’ve been familiar with for over 25 years now, and it’s a winning concept. It’s a concept that families definitely embrace. Clients embrace it. Some ICUs have embraced it. Our staff have certainly embraced it coming from ICUs, the CCRNs. And it works. It works without the shadow of a doubt. We’ve saved the healthcare system millions and millions of dollars in the pursuit of Intensive Care at Home, in the pursuit for providing quality of life for our clients and their families. So, again, I can’t stress enough that Intensive Care at Home is nothing but a win-win situation.

Also, like I said, not only have we adapted ICU policies to an Intensive Care at Home environment, out of that also came third-party accreditation for Intensive Care at Home. No other service provider, besides services in Germany, which is where I worked with as well, have achieved third-party accreditation for Intensive Care at Home in the English-speaking world. Because it is quite a unique skill set, and it takes years of practice. We’re constantly learning every day, constantly adapting to what our clients want, need, and desire.

So, just coming back to infection rates. Again, at home, infection rates are dramatically lower than in any hospital ICU. We’ve seen families reclaim their lives, parents, spouses, and children spending time together without constant hospital alarms and visiting hours. I also want to mention here that, for example, during COVID (Coronavirus disease), not one of our clients ended up with COVID. That is in spite of our staff working between ICU and our home care environment during COVID, because we know how to provide infection control safely. What I also want to stress here again is that quality of life at home improves dramatically. I’m not exaggerating for one minute here.

Again, if you’ve been exposed to ICU, whether it’s a patient or it’s a family member, especially long-term, there is no quality of life in ICU. There simply isn’t. There’s noise. There’s people talking 24/7. There’s lights going on and off 24/7. So much more controlled at home, because families sleep in their own beds, in their own rooms. You can engage in your daily routine at home, which is coming from you to us, and we deliver on that. In an ICU, it’s the ICU’s routine. It’s not your routine. At home, it’s your routine.

No more hospital infections at home and care is personalized 24/7. Again, not only will we work with creating a care plan with you that works for you, so we’ll be guided by you, but also we’re working with a team that you help us select, people you eventually know, like, and trust. You want a team at home that you know, like, and trust, that you know has your back.

That’s truly Intensive Care at Home, ICU-level care at home. It’s the future of long-term ventilation, tracheostomy, and anybody with complex care. The future here is not with disability support workers or with general registered nurses.

So, if you’re watching this and your loved one with cerebral palsy is in ICU and you’re told they need a tracheostomy or BIPAP long-term, you should reach out to us at intensivecareathome.com so that we can answer your question.

Also, if your loved one has been told they need long-term ventilation but the ICU team thinks it’s “not in the best interest” for your family member to have a tracheostomy, I urge you to reach out to us as well. We have helped many families in intensive care to advocate for tracheostomy for the right patient. Sometimes we advocate against it if we think that patients can be extubated, but we’ve also advocated for it when we think there’s enough evidence that a tracheostomy is the right next step and that a tracheostomy will help your family member to go home and live at home.

Now, I also want to heed a word of warning here. Last year, we had a cerebral palsy client at home. This young girl was BIPAP dependent. She didn’t have a tracheostomy, but she was heavily BIPAP dependent. She was on high flow nasal prongs as well, high flow nasal cannula with the Airvo machine, and was up to 15 litres of oxygen dependent. We advocated for an independent nursing assessment. The lady needed NDIS funding for 24-hour critical care nurses. It was clear from the reports that we had from our nurses that were doing some shifts there, but not enough, not 24/7, not many. There were disability support workers there most of the time, which we knew was unsafe because she had a lot of hospital admissions. Then, we pushed and advocated for 24/7 critical care registered nurses due to her cerebral palsy, chronic lung disease, BIPAP dependency, recurrent desaturations and complex medication needs.

Unfortunately, despite the strong evidence-based recommendation from an independent, very experienced critical care registered nurse and legal nurse consultant, who clearly demonstrated in her independent assessment that this lady needed 24 hours critical care nurses, the NDIS clearly ignored the assessment and the client tragically passed away at a very young age, an absolutely preventable death, highlighting the systemic failure of the NDIS to provide evidence-based care for high-acuity NDIS participants.

Now, I will say this is the exception, not the rule. Most of our cerebral palsy clients have 24-hour nursing care through the NDIS. Part of the issue there was also that the family was intimidated by the NDIS, which really cost their daughter’s life, and that’s extremely sad. You cannot be intimidated by anyone. The minute you’re intimidated by anyone, you’re on a downhill slope.

Also, what was a big issue is that the Cerebral Palsy Association at the time did not advocate for the client. I’ve got evidence for that. I do believe it needs to be mentioned publicly here, because the Cerebral Palsy Association has let this client down, just as the NDIS has let this client down, and that’s why she passed away. We’ve obviously lodged it to the NDIS Quality and Safety Commission as an incident, even prior to this lady passing away. I put on an incident in May last year where I clearly highlighted to the NDIS that if they’re not funding 24/7 critical care nurses, that this client will be at risk of dying. Unfortunately, my prediction became a reality. I am a clinician, after all. Then, we obviously lodged the incident again when she passed away, and all incidents were closed with no accountability. I do believe that the bureaucrats at the NDIS are responsible for this death, and I hope they sleep well at night.

It’s a very serious and heartbreaking example that underlines exactly why evidence-based nursing care with 24/7 critical care nurses, CCRNs, is not optional but it’s simply life-saving. This lady had chronic lung disease, BIPAP ventilation, had an independent nursing assessment, like I said, prepared by a very experienced critical care registered nurse consultant, who’s also a legal nurse consultant. And that assessment, which clearly outlined her need for 24/7 CCRNs to manage her ventilation, airway, and seizures, was ignored by the NDIS. Despite all the non-ambiguous evidence, despite the clear documentation of risk, the client passed away because she didn’t have the level of nursing care that she needed to support her condition and keep her alive, that was completely preventable.

So, if you have also, so to speak, support bodies like Cerebral Palsy Association not advocate for the right level of care, you need to come to us. We’ve helped many clients, whether it’s with MND or with cerebral palsy, where we think that the organizations are run by non-clinicians, with all respect, but non-clinicians don’t really understand what needs to happen at home. They don’t even understand what needs to happen in a hospital because they’re simply not clinical. T  hey come from a supportive place, but again, the biggest challenge for those organizations is also 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 have the right network to make things happen for those highly vulnerable clients.

So, the independent nursing assessment for this client clearly showed that without 24/7 CCRNs, desaturations, aspiration risks, and complex medication regime could lead to respiratory arrest, and tragically, that’s exactly what’s happened. That’s why we advocate so strongly for evidence-based home CCRN nursing care under the NDIS, following the evidence-based Mechanical Home Ventilation Guidelines that once again, you can see and find on our website at intensivecareathome.com.

This particular story for this particular client must serve as a wake-up call. The NDIS must start funding 24/7 critical care nurses for all participants with tracheostomy, BIPAP, and high-intensity care needs, not after they die, but before, when it still matters.

Like I said, I hope that the NDIS planners that were involved at the NDIS sleep well at night. I hope that the Cerebral Palsy Association sleeps well at night, the people in charge there. I have emails with supportive evidence that we advocated for 24/7 intensive care nurses for the client, where the Cerebral Palsy Association has said, “No, no, this can be done by support workers.” Again, the blind leading the blind. There’s a good chance that if you engage with the Cerebral Palsy Association, if your family member is complex, that they will tell you the same, and that your loved one is at risk of dying.

I encourage you reach out to us here at intensivecareathome.com. You have nothing to lose. We have so many case studies. Whereas, the Cerebral Palsy Association may not have as many case studies as they would like, because, again, the blind leading the blind. This is why we do what we do here at Intensive Care Hotline and Intensive Care at Home, making sure families in intensive care and at home get the right information and the right care before it’s too late.

If your loved one is at risk or currently in ICU with cerebral palsy, tracheostomy, or BIPAP, reach out to us at intensivecarehotline.com or intensivecareathome.com. We can help you get 24/7 ICU nurses at home, keep your loved ones safe, and avoid another preventable tragedy. Like I said, we’re also providing Level 2, Level 3 NDIS support coordination to help you with the funding that you need or your family member needs.

So, now, I need to wrap this up now. I hope you’ve got some value out of it. If you like my videos, subscribe to my YouTube channel. Click the Like button, click the notification bell. Most of all, share this video with anyone that will benefit from it. You can share it with other families who have family member in intensive care or potentially at home with cerebral palsy but don’t have enough help. Maybe they get told by NDIS support coordinators or by hospital coordinators, “There’s not enough funding.” Forget all about of that. We wouldn’t exist if that was the case.

I’m going to wrap this up here. If you have any questions, now is your last chance to connect with me live here on the StreamYard link, or type a question in your chat pad before I wrap this up. I continue to do these YouTube lives every week, every Sunday, 10:30 AM Sydney/Melbourne time. From next week onwards, it’ll be 6:30 PM Eastern Standard Time in the U.S. or in North America, which will be 3:30 PM Pacific Time on a Saturday in the U.S. and it’ll be just 11:30 PM on a Saturday night in the U.K. when I run these YouTube lives.

So, that’s it for today. That’s it from me. Like, comment, subscribe.

I wish you and your families all the best. Take care for now.

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a service provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia has created more intellectual property when it comes to Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012, was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a cabin crew instead of the pilot. Because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at high risk of dying if they don’t have a team of dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS support coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, and high performing team of critical care nurses in the community, we’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team if you are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular staff. So, if you’re looking for agency work, where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts, and you’re really keen on building solid relationships with us and with our clients.

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well. We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, or for home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. and in the U.K. and you’re watching this, and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website, or simply send us an email to [email protected].

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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.