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Dad Needs a Tracheostomy in ICU & Hypoxic Brain Injury, Can He Go Home with INTENSIVE CARE AT HOME?

Hi, it’s 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 otherwise medically complex clients including home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), home tracheostomy care  for adults and children that are not ventilated, Home TPN (total parenteral nutrition), home IV potassium infusions, home IV magnesium infusions, and home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management, which also includes palliative care at home. We have also sent our critical care nurses in the home for emergency department bypass services for the Western Sydney Local Area Health District the in-touch program.

Today, I have an email from Tunde who says,

“Hi Patrik,

My dad had an out of hospital cardiac arrest three weeks ago. They say he sustained a hypoxic brain injury. He’s still ventilated with an endotracheal tube. The doctors want to put in a tracheostomy and try to wean him off ventilation and make him palliative. What sort of care packages would be available to bring him home in-home intensive care? Is that an option or to have him sent to a nursing home with full nursing care? Thank you.

From, Tunde”

Tunde is in Brisbane in Australia. Now, Tunde, thank you so much for writing in. I’m very sorry to hear about your dad’s hypoxic brain injury, your dad’s situation.

Now, you haven’t shared how long your dad has been ventilated for. If it’s 10 to 14 days with the breathing tube, he probably needs a tracheostomy, assuming he’s not waking up and he can’t be weaned off the ventilator. So, that’s your first checkpoint. You should be checking in if it’s timely to now do a tracheostomy. That’s number one.

Once he has a tracheostomy and they need to try to wean him off the ventilator, that makes sense. What doesn’t make sense is you’re saying the doctors want to put in a tracheostomy and try to wean him off the ventilator and make him palliative.

If they want to make him palliative, which means end-of-life care, they should not do the tracheostomy and potentially extubate him, remove the breathing tube and let him pass away. I hope that is not what you want. So, there’s a little bit of contradiction there and maybe you’re not quite beyond the terminology.

So, in terms of care packages, there’s a number of care packages available in Australia, in particular. First off, you could go with the NDIS, the National Disability Insurance Scheme. We are fully registered for the NDIS for Intensive Care at Home nursing care.

Now, other care packages would be Aged Care package. It really depends on your dad’s age and NDIS usually stops at the age of 65. So, that could be one option for you. Aged Care packages are very limited to, I think it’s about $50,000 a year, which is really nothing, but your dad might have private health insurance, which is another option. Other options might be the private health insurance, if your dad has private health insurance or other funding sources are simply public hospitals.

You have to keep the following in mind, an intensive care bed costs around $5,000 to $6,000 per bed day. With Intensive Care at Home, we can provide intensive care at home services for approximately half of that cost. So, there’s a business case in there, a very strong business case.

On top of that, of course, it’s your dad’s quality of life. It is you and your family’s quality of life to be at home instead of in a noisy hospital and ICU environment where an ICU never sleeps. That brings no quality of life for patients and that brings a disturbed day and night rhythm for patients.

It probably goes hand in hand with you and your family spending day and night in ICU. It also goes hand in hand that ICUs need their beds. ICU beds are the most sought-after beds in any hospital in any healthcare service. There’s probably 5 other patients knocking at your dad’s ICU bed wanting to take it up. So, it’s a win-win situation all around. Plus, obviously cutting the cost by approximately 50%.

In terms of him going to a nursing home with a tracheostomy, probably not going to happen. Very few if any nursing homes are able to take tracheostomy patients, let alone ventilated and tracheostomy patients. There might be the exception to the rule, we could send our ICU nurses into a nursing home if they would take a patient with ventilation and tracheostomy with our service.

Now, here’s another thing you need to know. In 2024, we are the only service in Australia that has third-party accreditation for Intensive Care at Home nursing. There’s no other service in 2020 for that has achieved that level of third-party accreditation in the community. So, you will be in safe hands.

Also, we provide services that are evidence-based. You can look up the Mechanical Home Ventilation Guidelines on our website intensivecareathome.com. You would see that our services are evidence-based.

I hope that answers your question, Tunde.

You know where we are. You can reach out to me here at intensivecareathome.com. Call me on one of the numbers on the top of the website or send another email to [email protected].

Now, 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 an NDIS (National Disability Insurance Scheme) accredited service provider, TAC (Transport Accident Commission) in Victoria as well as WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland. We are also a DVA (Department of Veteran Affairs) approved service provider all around Australia. Our clients have received funding through public hospitals, private health funds, as well as departments of health.

Like I said, we are NDIS accredited, but we are also accredited for ACIS for the Australian community industry standards. Like I said, we are the only service provider within Australia that has achieved third-party accreditation for Intensive Care at Home nursing.

We are also providing Level 2 and Level 3 NDIS Support Coordination which is critical for most NDIS participants.

If you are at home already, maybe in a similar situation where you are ventilated with a tracheostomy, you already have a family member that’s ventilated or has a tracheostomy and you don’t have enough support, you don’t have enough help, your family member or yourself is going back to hospital all the time, feels unsafe, please know that there’s help at hand or if you are in ICU watching this and you have a similar situation, reach out to us. We can help you with that, with going home and keep you and your family member at home predictably.

So, if you are an NDIS Support Coordinator and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for more nursing care, I also encourage you to reach out. We can help you with the advocacy and we also provide NDIS specialist nursing assessments.

If you are a critical care nurse and you’re looking for a career change, we are currently offering jobs for critical care nurses now in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, as well as in Warragul, Victoria. If you have worked in critical care for a minimum of 2 years, pediatric ICU, ED, and you have ideally completed a postgraduate critical care qualification, we want to hear from you.

We are offering a tailor-made solution for our clients, which includes regular staff, our clients want to have the same staff coming over and over again because they are so vulnerable and it’s all about building those critical relationships and having regular and stable teams.

So, if you’re looking for agency work where you want to come and go, it may not be the right fit for you. But if you are interested in a long-term engagement with us and long-term engagement with our vulnerable clients and building those critical relationships, then this is a win-win situation for everyone.

If you are an intensive care specialist or ED specialist and consultant, we also want to hear from you. We are currently expanding our medical team as well. If you are an intensive care specialist and you have bed blocks in your ICU, or ED, we want to hear from you because we can help you take the pressure off your hospital beds and in many cases, you won’t even pay for it.

If you are a hospital executive and you have bed blocks in ICU, ED, respiratory wards, please reach out to us as well.

Lastly, if you’re in the U.S. or in the U.K. and you’re watching this, we want to hear from you as well. We can help you there privately.

Once again, all of that you get at intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

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

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification if you’re a subscriber to my YouTube channel or a subscriber to our email newsletter at intensivecareathome.com.

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.