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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 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 at home, adults and children, which includes BIPAP (Bilevel Positive Airway Pressure), 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, and we also provide palliative care at home.

We have also sent, and we are sending our critical care nurses into the home for emergency department bypass services, and we have done so successfully in the past for the Western Sydney Local Area Health District, their in-touch program.

So today, I want to answer a question actually from one of our clients that we’re currently working with, who has their loved one still in ICU but is thinking about getting him home. Here is the situation, the client is saying, “I’m aware of the risks and dangers of bringing my husband home without ICU nurses, and I’ve been thinking about it, and I have not signed anything yet as far as the whole thing is concerned.”

Now, our client’s husband is in ICU with a tracheostomy. He’s just pulled out his nasogastric tube and he needs a PEG (Percutaneous Endoscopic Gastrostomy) to go home because of his inability to be decannulated, having the tracheostomy removed by now. He’s off the ventilator already but he still has the tracheostomy and the PEG tube.

She thinks that the danger has passed to take him home with intensive care nurses. So, that’s an option that she’s considering. Obviously, that’s something we do here at Intensive Care at Home with 24-hour critical care nurses because that is what is needed for someone with a tracheostomy and a PEG tube at home. It’s evidence-based as per the Mechanical Home Ventilation Guidelines, which are evidence-based. You can look them up on our website and I have put a link towards it that someone with a tracheostomy needs critical care nurses, 24 hours a day, with a minimum of two years critical care nursing experience. So, they are actually tracheostomy competent.

Now, she’s also worried that once her husband is at home that he needs to start eating and drinking again, even though he will have a PEG tube and what that would look like. Now, again, if someone has a tracheostomy, the best way to start eating and drinking again is to do some swallowing assessments and some speech exercises with the speech pathologist. The cuff needs to be put down on the tracheostomy to see whether the patient can swallow or not.

Now, her husband is also on dialysis because he’s in chronic kidney failure and whilst dialysis can be done at home with peritoneal dialysis, it is important that it can be done as an outpatient as well so that the dialysis center is accessible and then dialysis can be done as an outpatient but that all requires the skills and the expertise of 24-hour intensive care nurses or critical care nurses at home to make that a reality and in order to be safe at home.

Like I’ve been saying on this blog before, when patients have gone home with a tracheostomy, not even ventilated without 24-hour intensive care nurses, patients have died. There’s enough evidence out there for that. That’s why the Mechanical Home Ventilation Guidelines exist as the gold standard.

Anyone who wants to lower standards when it comes to tracheostomy and/or ventilation at home is potentially signing off on a death warrant. It’s almost like a death sentence. We’ve seen it over and over and over again. So, it is really highly negligent for anyone who wants to send home a patient with a tracheostomy with general registered nurses without ICU experience, let alone with support workers, or disability support workers. In my mind, that’s a crime and I will stand by everything that what I’m saying here.

So, it’s good that, we’re moving one step closer to getting your husband home. If you’re watching this and I know you do, then it needs to be with critical care nurses, 24 hours a day. Keep in mind, an ICU bed costs $5,0000 to $6,000 per bed day and Intensive Care at Home is approximately 50% of that cost. So once again, it’s a win-win situation for everyone, including for the funding body who’s funding the ICU bed.

Tracheostomy tubes can be changed at home, weaning can be done at home, PEG tube changes can be done at home, dressing changes, but also feeding can be done at home, as well including oral feeding assuming that a speech therapist is involved with who can do the swallowing exercises. So, I think it’s all steam ahead here for going home.

Once the funding and the critical care nurses are in place, we will hire a team of critical care nurses that is suitable for home care. You will see that your husband will be home in no time, and he will be in very good hands.

So, with Intensive Care at Home currently, we are 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) approved service provider in Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, NIISQ (National Injury Insurance Scheme in Queensland), iCare in New South Wales, DVA (Department of Veteran Affairs) all around the country. Our clients have also received funding through public hospitals, private health funds as well as departments of health.

We are employing hundreds of years of intensive care and critical care nursing experience combined in the community, that is unmatched in 2024 in Australia, I believe, to bring this high level of skill into the community.

Now, if you’re at home already in a similar situation where your family member or yourself is ventilated, tracheostomy, and you feel unsafe or you’re wondering whether you would get 24-hour critical care nurse at home, I highly encourage you to reach out to us.  We have helped pretty much all of our clients to get the right level of funding because otherwise we wouldn’t be in business.

We help our clients advocate for what is the right thing for them and what is also safe. We have put stops to ICU readmissions with our service from Day 1. Ventilated clients who were bouncing back into ICU or others have died who didn’t get our service in the early days. You are at high risk if you’re at home with a ventilator and tracheostomy without ICU nurses. Let’s be very clear here. Or if you’re in a hospital in a similar situation and you want to go home, please reach out to us.

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

We are also providing our own Level 2 and Level 3 NDIS Support Coordination which is critical for most NDIS participants in those complex situations. We’re also providing TAC case management.

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

Because 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 very vulnerable and it’s all about building those critical relationships and having regular and stable teams.

So, if you are looking for agency work where you can come and go, this may not be the right fit for you because we’re looking to engage with you on a long-term basis and our clients want to engage with you on a long-term basis. So, it’s all about building those critical relationships long-term so that it remains a win-win situation for everyone.

If you are an intensive care specialist or ED specialist, we also want to hear from you. We are currently expanding our medical team as well. We can also help you eliminate your bed blocks  in ICU, ED for your long-term patients in particular or for patients that are coming back over and over again. We are here to help you to take your pressure off your ICU and ED beds, in most cases, you won’t even pay for it.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, please reach out to us as well. We can help you there.

Lastly, 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.

Once again, contact 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].

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

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification for the YouTube live if you’re a subscriber to my YouTube channel, or if you are 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.