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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children with tracheostomies, and also otherwise medically complex adults and children at home, including Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, and IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home, and sometimes even ventilator weaning at home.

We also send our critical care nurses into the home to avoid emergency department admissions (ED admissions). So, we’re also providing an ED bypass service into people’s homes, as well as into residential aged care or any other facilities where you would like our service.

Now, I want to answer a question today that I had from Kat. Let me read that Kat’s email and answer a question, she says:

“Hi Patrik,

My dad was admitted to ICU and intubated 10 days ago for influenza A with COPD and emphysema. We were told they would wean him off sedation on Day 4, but then we were told he wasn’t ready. The ICU doctor says he is about 20% of lung function. They are now saying that a tracheostomy is the next step but have not tried to wean him off sedation or ventilation.

Being trapped in an ICU on the ventilator to die is his biggest fear as he saw both of his parents pass away in ICU. I am looking for options to get him a better quality of life. If he cannot come off the ventilator, I want to be his strongest advocate in receiving the care and treatment he needs, both medically and mentally.

Can you help? From Kat.”

Well, thank you, Kat, for writing in and for asking such a detailed question.

Now first off, if his lung function is at 20% capacity, that’s really low. The question is why? I mean, he’s got a history of influenza A, COPD, emphysema, is there something else going on? Does he have pneumonia? Does he have ARDS (Acute Respiratory Distress Syndrome)? Do they think there is a way forward to improve his lung function? Does he need to go on ECMO (Extracorporeal membrane oxygenation) to improve his lung function? Does he need nitric oxide? Epoprostenol? Any other nebulizers that might help him to improve his lung function? It’s all depending on his condition.

Tracheostomy might be the next step here if he can’t be woken up, and if he can’t be weaned off sedation. Also, keep in mind, it would be difficult to wean him off sedation if he’s at 20% of lung function. So, here’s the deal, if he had 20% of lung function and they take off sedation and he can’t breathe, with no lung function, it’ll only distress him. Therefore, keeping him sedated and working towards the tracheostomy might be the better way to go here. By the same token, if he’s at 20% of lung function, he might be on a high PEEP (Positive end-expiratory pressure), high oxygen levels, FIO2 (Fraction of Inspired Oxygen) levels and that might also rule out to do a tracheostomy for now. Oxygen levels have to be below at 40%, generally speaking, and PEEP has to be below 10 / 7.5, in order to perform a tracheostomy safely.

So, having said all of that, if he can have a tracheostomy and he can’t come off the ventilator because his lungs are simply too poorly; mentally, your folk talking about what he needs mentally and medically, then the next best step is probably Intensive Care at Home because he would probably be stuck in an ICU for long periods of time and then Intensive Care at Home might be the much better option as well, including end-of-life care.

You mentioned your dad doesn’t want to die in an ICU because he’s seen his own parents die in an ICU. So, for him to go home for end-of-life care with Intensive Care at Home might be the much better option here. I mean, we’ve taken many clients home from intensive care with ventilation, tracheostomy and other medically complex conditions, and that is probably your best option here, as well your dad’s best option. Hopefully, you won’t need any of any of it, but if he does, then you have absolutely come to the right place with Intensive Care at Home.

And it’s the same, if you have a loved one in a similar situation, you should contact us as well. There are many patients stuck in ICU long-term on a ventilator with a tracheostomy and as you know, by now, your loved one doesn’t have any quality of life. You don’t have any quality of life. The ICU that is occupied could be used for another patient. Now, the ICU has an interest in emptying their beds, and we provide a cost-effective solution to that, it’s about 50%. What we do costs about 50% of an intensive care bed and we do it in a holistic patient and family-friendly environment.

So, you might be watching this, and you might be at home already, and you might be on a ventilator, tracheostomy, BIPAP, and CPAP. You might not be ventilated but have a tracheostomy and you don’t have sufficient support; you should also reach out to us.

A lot of clients that we started with, they were home already, but they bounced back into ICU all the time, so they didn’t have the right support. So, if you’re watching this, you’re at home or you have a family member at home, please reach out to us.

You can find us at intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

Currently, we are operating all around Australia in all major capital cities, including regional and rural areas. We are a NDIS (National Disability Insurance Scheme) accredited service provider, a TAC (Transport Accident Commission) approved service provider in Victoria as well as WorkSafe. We are an iCare approved service provider in New South Wales as well as NIISQ (National Injury Insurance Scheme) approved service provider in Queensland. We are also a DVA (Department of Veteran Affairs) approved all around Australia. We and our clients have received funding through public hospitals, departments of health as well as through private health funds. So, please reach out to us if you need help.

We are also providing Level 2 and Level 3 NDIS Support Coordination if you need help with that. We’re also providing NDIS specialist nursing assessments if you need that for yourself or for your NDIS participants if you are a NDIS Support Coordinator watching this. If you are a NDIS Support Coordinator watching this, and you need nursing care for your participants, please let us know. Or if you need funding for nursing care, once again, we can help you with the nursing assessment and with the advocacy. We’ve done it many, many times. Or if you are a TAC or iCare or NIISQ or DVA case manager and you’re looking for nursing care specialist, nursing care for your clients, we want to hear from you as well.

Like I mentioned, we’re also sending ICU nurses and critical care nurses into people’s home and as residential aged care facilities to avoid emergency department presentations. So, we’re therefore providing an emergency department bypass service.

If you are a critical care nurse and you’re looking for a career change, we want to hear from you as well. If you have worked for a minimum of two years in critical care ICU or ED or pediatric ICU, and you ideally have completed a postgraduate critical care qualification and you want to work for us, we currently have jobs in Sydney, Melbourne, Brisbane, in Albury, Wodonga on the New South Wales, Victorian Border in Bendigo, in Country Victoria, as well as in Warragul in Country Victoria. We absolutely want to hear from you.

We are looking for ICU nurses or CCRNs that want to complement our team, people who are team players and people who are looking for regular work. We are a service provider with a tailor-made solution for our clients and we are not a nursing agency that has people coming and going and picking up shifts here and there, that’s not us. We really pride ourselves on providing that “tailor-made solutions” to our clients, and that includes a regular team that does regular shifts with the clients, so they can get to know the client and the other way around, the client can get to know you and you can provide the exceptional care to our clients. So, if you are looking for agency work and you want to come and go and pick up shifts here and there as you want, please don’t apply. That is not us, it’s not for you. Only apply if you’re genuine and want to make a difference to our clients lives and if you want regular work and that includes working with our clients on a regular basis.

If you are an intensive care specialist or ICU consultant, we want to hear from you as well. We are currently expanding our medical team.

Please reach out to us once again 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’re an ICU consultant or intensive care specialist, and you have bed blocks in your ICU, which I know you do after having worked in ICU for nearly 25 years myself, I encourage you to reach out to us as well. We can help you eliminate your bed blocks, but more importantly, we can improve the quality of life and sometimes quality of end of life for your patients and their families, and your ICU won’t pay for it.

If you are a hospital executive watching this, we also want to hear from you because, once again, we can help you eliminate bed blocks in ICU, pediatric ICU, ED, and also on respiratory wards, please reach out if you want to have a conversation.

Website again is 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 YouTube channel for regular updates for Intensive Care at Home, and also 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.

Thank you for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.