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I have an email from a reader who says, “ICU ventilation and tracheostomy care is impossible with the spinal cord injury in ICU. Moving too much, not able to wean off the ventilator and the tracheostomy due to the routine care given in ICU makes it hard for my loved one in ICU. Is going home with Intensive Care at Home the best option here?”

My name is Patrik Hutzel from intensivecareathome.com and today I want to break down the question from this reader who’s asking, “Is it best to go home for their family member with a spinal injury on ventilation with tracheostomy? Because weaning them off the ventilator is going to be really hard in ICU due to ICU routines and no quality of life really.”

So, let’s look at this in more detail, and your concern is very valid with the spinal cord injury, especially if it’s a high level like cervical spinal injury. You haven’t really mentioned what level of spinal injury it is, but if you are talking about ventilation and tracheostomy weaning, it’s really hard. Maybe it’s even impossible if it’s a C1 or C2 spinal injury. So, it really comes down to where the level of injury is.

That also means that your family member probably has little or no control over the muscles needed to breathe independently and that can make weaning off a ventilator extremely difficult or potentially even impossible. Add to that the constant stimulation from ICU routines, turning, suctioning, noisy surroundings, 24 hours a day, no natural daylights. Especially overnight, lights on, lights off, people around, difficult to sleep, and it can be very exhausting and even distressing for someone trying to recover in an ICU especially long term. Also, often, from my extensive experience as an ICU nurse, day and night rhythms are disturbed, again, because of the routines in ICU because of noise in ICU, lights on, lights off, depending on what’s happening.

So, in that context, yes. Going home with an experienced home care service like Intensive Care at Home is a significantly better option for most patients and families in situations like that, and here is why.

It is absolutely more comfort and more stability. A calm, familiar home care environment reduces stimulation and allows for better rest and healing, and of course, allows for a much better quality of life, for example, all of our clients have community access. Compare that to an ICU where patients and their families are stuck in an ICU bed or ICU cubicle. Compare that to going home with critical care nurses at home, and then also having community access and improve the quality of life.

Next, individualized attention and individualized rosters, because you’re not sharing staff with dozens of other patients, the care with Intensive Care at Home is much more focused and much more tailor-made. Also, reduced ICU complications, lower risk of hospital acquired infections and ICU delirium.

Next, family involvement. You’re closely involved in care decisions and daily interactions, and you can create your own routine.

Next, same level of ventilation support. These services like Intensive Care at Home provide intensive care level care at home, including tracheostomy and ventilator management with intensive care trained and critical care trained nurses only.

So, what else do you need to consider? You need to consider that the home is equipped and safe power backup suction equipment emergency access, and so forth, but also that all the equipment is there like hospital bed, like hoist or lifting machine, suction machine, backup ventilator, backup suction machine, oxygen, nebulizers, monitors, but all of it is there. But we can help you with that because we’ve set up many home care environments when patients go home from intensive care to a homecare environment.

Also, obviously funding needs to be in place, but once again, like I’ve repeated here many times on this channel, funding is not even the problem because an ICU bed costs $5,000 to $6,000 per bed day. Intensive Care at Home costs around half of that. Obviously, the quality of the home care team is critical, but because we exclusively work with critical care trained nurses that have a minimum of 2 years critical care nursing experience and similar to ICU, all of our staff or minimum of 50% of our staff have a critical care nursing qualification, and you get the same level of care there at home.

So, 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:

• Genuine alternative to a long-term stay in intensive care/ long-term acute care
• Home care services for ventilated adults & children with tracheostomies
• Tracheostomy care
• Home care services for patients on non-invasive ventilation – Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure) 
• Home TPN (Total Parenteral Nutrition)
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Provides central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Provides nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Palliative care services at home
• Use cough assist machines for our clients for airway clearance

We are 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 the emergency department.

That also means we’re 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 cost between $2,500 to $3,000 per day and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. But 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 at home is much improved surrounded by families.

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

We are currently the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this level of accreditation since 2012. No other service provider has achieved this high level of accreditation in the community and has created more intellectual property for 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 if you’re stuck in an ICU, or if you’re going to hospital and ED (emergency department) all the time, and you realize that you don’t have the right level of support, I’ll give you another tangible and real-world example today, very similar to the one I gave you a minute ago.

One of our first clients when we first got started over 10 years ago, 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 dangerous and negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with the 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 critical care nurses looking after them 24/7. This is actually evidence-based and it’s 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 a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind would do that in a home care environment in the community?

So, this client found out about us eventually and the ICU that he went back to all the time also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with the client, we sent him intensive care nurses, 24 hours a day. He never, ever went back into ICU ever again and we were proving our concept there very fast.

We can do the same for you if you’re not safe at home which includes the advocacy for funding that goes along with it. We have always successfully advocated for our clients. Otherwise, we would not be in business. The same is applicable for those stuck in an ICU, similar to our case study today, or going back to ED all the time, so what you’re looking for? Reach out to us, we’ll make it happen for you as well. We can take you through the right steps including NDIS or other funding bodies, and the advocacy that needs to go along with it.

Which is also why we are providing Level 2 and Level 3 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’re looking for funding for nursing care for your participants, and you don’t know how to go about it and what evidence to provide, I encourage you to reach out to us as well. We will help you with the right level of funding and with the right level of advocacy. We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

If you are a critical care nurse and you’re looking for a career change, and you want to join a very progressive, dynamic, high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined. If you are looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and 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 have a disclaimer, 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 very vulnerable and very special, and 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 if you’re really keen on building relationships with us and with our clients.

If you are 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 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, 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. or 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].

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

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.