Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults & Children with Tracheostomies whilst providing quality care and where we also provide tailor made solutions for hospitals and Intensive Care Units to save money and resources where we provide win-win situations for all of our stakeholders and clients.
In last week’s blog, I talked about,
You can check out last week’s blog by clicking on the link below this video:
In today’s blog, I answer another question from one of our readers and potential clients. Katie is writing in and she says,
I Want Information from my Husband Who Has Been in ICU for Six Weeks, on a Downward Cycle and on a Ventilator. Can He Go Home?
So I read out Katie’s question here. Katie writes,
I am gathering information for my husband who has been in intensive care now for six weeks with a cycle that continues and doctors and nurses who are very nice, but unable to get to the bottom of things or get the right dosages of medications.
As I said, he has been in ICU for six weeks with a cycle of going on with low blood pressure and poor kidney perfusion, complicated by atrial fibrillation and high heart rate. We are looking to bring him home, but need a knowledgeable nursing team.
Before he’s going home, we know he needs a tracheostomy and at the moment he is still on a breathing tube and a ventilator. He doesn’t have a tracheostomy yet because he’s also got COVID-19 and the ICU team is reluctant to do a tracheostomy just simply because of the risk for the staff and also because he’s got high PEEP, high oxygen requirements up to 80%, and simply he hasn’t been well enough to do a tracheostomy.
What should we do? Can we get my husband home?
Thank you for writing in and thank you for sharing your husband’s situation. It sounds to me like your husband is a while away from going home. The next thing that needs to happen is he needs to have a tracheostomy first. Once he has a tracheostomy, then he needs to come off all the medications that he’s on.
You are describing in right dosages of medications, you’re probably referring to sedation and opiates. As soon as he has a tracheostomy, the intensive care team should be able to reduce sedation and opiates, and then hopefully slowly wean him off the ventilator.
But if he’s on 80% of oxygen and a PEEP of 12, it could be very difficult for them to do a tracheostomy. He’s not stable enough. And also currently with COVID the risk of staff getting infected when a tracheostomy is done is fairly high.
The other thing you mentioned is he’s currently in the ICU with a cycle going on with low blood pressure and poor kidney perfusion, complicated by atrial fibrillation and high heart rate. So again, Katie, that needs to be brought under control first. He needs to get off the inotropes/vasopressors for low blood pressure and the atrial fibrillation needs to be brought under control as well.
Often how that happens in ICU is with medication such as Amiodarone, Digoxin, especially for fast AF, as well as potentially a cardioversion, which is an electrical shock. Once that’s under control, once he’s off sedation, once he’s off opiates, once he’s off the inotropes and vasopressors, once the atrial fibrillation is under control only then can you look at options such as intensive care at home.
So it’s probably a little bit too early for you in that cycle. What you might want to do as a next step, Katie is have a look at our sister website, intensivecarehotline.com where we also provide consulting and advocacy for families in intensive care.
Because at the moment I feel like it’s a difficult situation for you and your family, because you are unsure about what the next steps are and a lot of that we talk about at our sister site intensivecarehotline.com.
Once your husband has the tracheostomy and can be weaned off the ventilator, that’s when you definitely should be looking at options, such as intensive care at home, quality of life at home will be so much better.
At the moment, I would assume you are locked out of ICU because of COVID. But generally speaking, once all the boxes have been ticked that which we spoke about, going home is almost a no brainer. And yes, like you said, in your email, you need a knowledgeable nursing team and you definitely need ICU nurses at home as well for a ventilator and a tracheostomy.
So absolutely you do need a knowledgeable nursing team and that’s what we believe we can provide to you at intensive care at home.
So I really hope that answers your question and thank you for tuning into this week’s blog. Take care.
Now, if you have a loved one in intensive care and you want to go home with our service intensive care at home and if you want to find out how to get funding for our service and how it all works, please contact us on one of the numbers on the top of our website, or send me an email to [email protected] That’s Patrik, just with a K at the end.
Please also have a look at our case studies because there we highlight more about what we can do for clients, how clients can live at home with ventilation and tracheostomies and you can look at our case studies as well at our service section
And if you are at home already and you need support for your critically ill loved one at home, and you have insufficient support or insufficient funding, please contact us as well. We can help you with all of that.
And if you are an intensive care nurse or a pediatric intensive care nurse with a minimum of two years, ICU or pediatric ICU experience, and you ideally have a critical care certificate, please contact us as well. Check out our career section on our website. We are currently hiring ICU and pediatric ICU nurses for clients in the Melbourne metropolitan area, Northern suburbs, Mornington Peninsula, Frankston area, South Gippsland, as well as Wollongong and Wagga Wagga in New South Wales.
So we are also 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.
Also, we have been part of the Royal Melbourne health accelerator program in the past for innovative healthcare companies.
Thank you for watching this video and thank you for tuning into this week’s blog.
This is Patrik from intensive care at home, and I’ll see you again next week in another update.