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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 weeks blog I talked about
LOOKING AFTER VENTILATED PATIENTS WITH TRACHEOSTOMIES AT HOME IS LIKE FLYING A PLANE, YOU CAN ONLY DO IT WITH SKILL AND EXPERTISE!
You can check out last week’s episode by clicking on the link here.
In this week episode, I want to publish another case study
From PICU to home, a toddler approaching end of life at home!
Last year we have been asked to help a young family leaving a paediatric ICU with their 15 month old toddler.
The toddler had spent a few many months in hospital and PICU after it had been diagnosed with a very rare hereditary genetic disease.
The disease caused respiratory and cardiac complications that required the toddler to spend many months in PICU.
The toddler gradually deteriorated since it got first diagnosed with the disease and it came to the point where the family and the PICU team decided that further active treatment would be futile for the toddler and would only prolong the toddler’s suffering.
The family only had one wish and that was to leave PICU and let their toddler approach the end of their life in a more holistic and family friendly environment!
The toddler had recurrent Hospital and PICU admissions over the previous few months.
The toddler suffered from respiratory symptoms and recurrent episodes of very distressing gagging and vomiting.
He had a few weeks where he was intubated, in an induced coma and he eventually got extubated on to BIPAP.
The gagging and the vomiting was also a result of the toddler needing frequent BIPAP ventilation, therefore the symptoms had been difficult to control.
Nasogastric feeds had also been reduced to minimise the risk of vomiting and aspiration.
BIPAP ventilation was also required due to increasing and worsening tachypnoea.
The energy of the toddler had been gradually declining.
The focus was shifting from active care to comfort care.
Times of enjoyment for the toddler had become far and few in between.
BIPAP ventilation on FIO2> 40% was necessary to keep the toddler’s oxygen saturation above 85%.
It became more and more difficult to manage the increasing secretions despite the usage of Glycopyrrolate and Hyoscine.
As soon as the toddler came off BIPAP for secretion management and suctioning, oxygen saturations dropped to less than 85% and the toddler became zyanotic very quickly.
The toddler was in a position where it couldn’t maintain their airway any longer!
Overall the family was hoping to spend some “normal” time at home with their dying toddler with family and friends around them to celebrate the toddler’s short life!
Therefore, in order to make a smooth and safe transition from PICU to home and give the family quality time with their toddler, the family needed our specialist skills with ICU/PICU nurses coming into their home that could provide the expertise to manage such a complex situation at home instead of PICU.
The toddler was transferred home via road ambulance.
All equipment that was needed to look after the toddler at home was ready for use. This included a monitor, suction machine, guedel airways, BIPAP machine, feeding pump, oxygen concentrator as well as medications to manage the inevitable discomfort.
Morphine, Midazolam, Clonazepam and Levomepromazine was ready to be given for symptom management.
The family celebrated the life of the toddler on the day of discharge from PICU with family and friends in their own home and made it memorable for everyone!
You can read our other case studies here
Critical Care Nurse consultant
INTENSIVE CARE AT HOME
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!