Welcome, welcome, welcome. If you have a child with a tracheostomy or your baby or toddler is still in the neonatal or pediatric intensive care unit right now and you’re terrified about what comes next, you are in the right place and I’m so glad you’re here.

My name is Patrik Hutzel. I’m an intensive care specialist nurse founder of Intensive Care at Home, and for the next 45 to 60 minutes, we’re going to talk about everything parents need to know about bringing a child with a tracheostomy home safely, with professional support, with confidence, and importantly with real quality of life.

So, this is our Intensive Care at Home Pediatric Special, whether your child is on a ventilator, whether your child is just tracheostomy dependent, whether your child is dependent on BiPAP or CPAP without a tracheostomy, whether you are in the early days of a neonatal ICU admission or a pediatric ICU admission, or you’re somewhere in the middle of a very long discharge journey, this livestream is for you.

If you’re watching this on replay, then I also want to welcome you because I know we have quite a number of viewers watching my videos on replay.

So, before we go any further, if you’re watching this on YouTube right now, please do two things for me. Hit the subscribe button. I put out free videos every week for families in intensive care or for Intensive Care at Home. Hit the like button and comment below. Let me know where you’re watching from and what your biggest question is about taking your child home, or you might have a child at home already and you realize you do not have the right level of support and you realize that Intensive Care at Home is probably an option, and that engagement tells YouTube to show videos like this more often and also to more families who need it. So, please do that, it really helps.

So, what we are covering today is what pediatric ICU or neonatal ICU discharge actually looks like for a child with a tracheostomy or for a child with a ventilator without a tracheostomy. Tracheostomy care at home, what you absolutely need to know, home ventilation machines, alarms, and how 24-hour intensive care nursing works at home, NDIS support coordination level 2 and level 3, and how we help families navigate funding, real stories from real families we’ve supported across Australia since 2012. That’s how long we’ve been operating here at intensivecareathome.com, and we’ll take your live questions at the end if you have any. So, let’s get into it.

So, let me take a moment and tell you about who we are at Intensive Care at Home and why we do this work, because I know some of you’re watching for the very first time and trust matters. Intensive Care at Home is Australia’s first accredited, should say first third-party accredited Intensive Care at Home nursing service. We are the most specialized home nursing provider for children and adults on ventilation with tracheostomies, ventilation without tracheostomies, tracheostomies without ventilation. We also provide ventilation weaning at home, cough assist management at home, home TPN (Total Parenteral Nutrition), home IV potassium, home IV magnesium, home IV fluids, home IV antibiotic infusions. That means we’re managing central line, PICC (Peripherally Inserted Central Catheter) lines, Hickman’s lines, port catheters at home as well. We manage nasogastric tube, nasojejunostomy tubes, PEG (Percutaneous Endoscopic Gastrostomy) tube, PEJ (Percutaneous Endoscopic Jejunostomy) tubes, as well as SPCs (Suprapubic Catheter) and IDCs (Indwelling Catheter) at home.

We are not a general nursing agency or nursing service. We exist specifically for the highest acuity, most complex patients in the community, the ones that hospitals don’t know quite what to do with at discharge time, the ones the system often forgets about. Our clinical team is made up of adult and pediatric intensive care nurses, ICU trained, pediatric ICU trained specialist nurses who have worked in some of the most demanding critical care environments in Australia and around the world. When your child comes home with us, they’re being looked after by nurses who understand ventilators, who understand tracheostomies, who understand airway management, who understand exactly what a pediatric tracheostomy means at two o’clock in the morning.

We operate across Melbourne, Sydney, Brisbane, Adelaide, and Perth, as well as all metropolitan and regional and remote areas in Australia. We support families 24 hours a day, seven days a week because a tracheostomy or a ventilator doesn’t take the weekend or a night off. We are also an NDIS approved provider. We provide level 2 and level 3 NDIS specialist support coordination, which we will talk about in detail later in this show, because for many of the families watching NDIS funding is going to be a critical part of how you pay for care at home, including Intensive Care at Home.

Just a little bit about me, what makes me qualified to talk about this topic. I’m the founder of intensivecareathome.com. Like I said, I am a critical care nurse by background. Having worked in critical care nursing for over 25 years in three different countries where I worked as a nurse manager for over five years in intensive care, I’ve done adults and pediatric ICU. I have been part of setting up Intensive Care at Home in Germany way back when in the late 1990s, early 2000s as part of a pioneering service there. We were the first ones setting up Intensive Care at Home in Germany successfully. And then as I went on traveling, I set up Intensive Care at Home successfully here in Australia in 2012, and that’s how long we’ve been operating since then.

I’m also a consultant and advocate for families in intensive care, and it is also important to know for you that we are employing hundreds of years of intensive care nursing experience combined in the community. That’s our level of expertise that we’re bringing into the community. Most of our critical care nurses, adults and pediatric, have decades of ICU experience, which is combined. We are employing hundreds of years of intensive care and pediatric intensive care nursing experience in the community combined. No other service provider hands down brings that level of expertise into the community like we do.

You’ll find everything about Intensive Care at Home, case studies, testimonials, our full list of services and how to get in touch with us at intensivecareathome.com, you can get in touch with us there, and for families who need immediate personalized expert guidance. Our sister service is intensivecarehotline.com where you can book a one-on-one call or consultation with myself or with one of our senior ICU nurses if you have a loved one in intensive care and you need help right now, that obviously includes pediatric intensive care.

We have supported hundreds of families across Australia, but also worldwide. Families who were told their child or their loved one might never leave pediatric ICU, families who were scared, exhausted and running out of hope. We helped those families take their child home safely with clinical support they can actually rely on. And we also have always successfully helped advocate for the right level of funding for our service because let’s face it, our service cuts the cost of an intensive care bed by around 50%. So, any funding body will have an interest in funding our service.

Now, let’s now talk about the moment that terrifies almost every family in your situation, the pediatric ICU discharge conversation. Maybe you’ve already had it. Maybe the registrar pulled you aside last week and said, “We think your child is stable enough to go home.” And instead of feeling relieved, you felt absolutely terrified because your child still has a tracheostomy, your child is still on a ventilator and you thought, how is this even possible? How can I take my baby home safely? Or maybe you’re at the other end. You’ve been in the pediatric ICU for 6 months, 8 months, 12 months, and you love the nurses there, you trust them, and honestly, you’re scared of leaving even though every bone in your body wants to take your child home and get back to some level of normality, get back to family life.

So, let me walk you through what the pediatric tracheostomy PICU discharge process actually looks like and where families often get stuck and how we help to unstuck them. So, let’s look at the typical PICU discharge journey for a tracheostomy child. The child is medically stable but still requires a tracheostomy for airway management, often due to airway abnormalities, neurological conditions, chronic lung disease, or complex congenital conditions.

The PICU team begins talking about transition planning, which sounds organized but can often be fragmented. You are asked to learn a long list of clinical skills, how to suction the tracheostomy, how to manage the ventilator, how to change tracheostomy ties, what to do in emergencies that we prevent in the first place. And you’re asked to learn a long list of clinical skills that I just mentioned, that nurses, critical care nurses in particular, take years to train, obtain, and then have regular clinical exposure to so that they feel competent and confident, and they’re asking you to do that at lightning speed.

You’re told you need equipment at home, a ventilator, suction machine, oxygen, emergency kit, monitoring equipment, spare tracheostomies, nebulizer, Swedish noses, HME filters, and the list goes on. A complex web of referrals begins, equipment companies, community nursing, respiratory teams, pediatric teams, NDIS, local councils, and it can feel like no one is coordinating any of it. Discharges get delayed, sometimes for weeks, sometimes for months, not because your child isn’t ready, but because the system moves very slowly. This is where families reach out to us and this is where we make the biggest difference because the question isn’t whether your child can go home with the right support in place. They absolutely can. The question is whether the discharge is planned well enough and whether you have clinical support that is genuinely equipped and aligned to manage your child’s complexity at home so that your child can stay at home predictably and permanently.

If you are having a child in ICU, we also see common PICU discharge mistakes we have seen. For example, discharging without 24-hour-7 nursing plan in place, underestimating the complexity of home ventilation management or tracheostomy management, over-relying on parents to manage emergencies alone, inadequate NDIS funding plans at the time of discharge. If you’re in the middle of a pediatric ICU discharge process right now and something feels rushed or under-planned, please reach out to us before discharge. It is much easier to build a safe plan before you leave the hospital than to fix problems when you’re already home. If you are already home and you’re watching this, you might realize without Intensive Care at Home, your setup is not working, your setup is very risky. But I will make a separate video about that, that if you’re at home already with your child, with your ventilated tracheostomy child, how our service will make a difference.

Let’s now look at tracheostomy 101, what parents need to know. Let’s get a little bit more clinical here because the more you understand about your child’s tracheostomy, the more confident you will feel. And confidence is something I really want to give you today. A tracheostomy is a surgically created opening in the neck called a stoma, through which a tracheostomy tube is inserted directly into the trachea, the windpipe. For children, this is almost always done because there’s either an airway problem above the level of the trachea and need for long-term ventilation support or both.

Common reasons a child might have a tracheostomy include subglottic stenosis, narrowing of the airway below the vocal cords, laryngomalacia or tracheomalacia, airway collapse during breathing, neurological conditions that affect airway control and swallowing, chronic lung disease, especially bronchopulmonary dysplasia in premature babies, congenital heart conditions with secondary respiratory compromise. Conditions requiring long-term mechanical ventilation with or without a tracheostomy.

Here are the most important things parents need to understand:

1.  Suctioning.

Suctioning is the most frequent clinical task our nurse would perform at home. It means using a suction catheter to clear secretions, mucus from inside the tracheostomy tube and the trachea. Children with tracheostomies cannot clear their own secretions effectively.

So, this needs to happen regularly, sometimes every 15 to 30 minutes in an unwell child. At Intensive Care at Home, our nurses manage all routine and emergency suctioning 24 hours a day, but we are also making sure parents understand what’s happening and why so you’re never in the dark about your child’s care and safety.

2.  Tracheostomy tube changes.

Tracheostomy tubes need to be changed regularly, typically every one to four weeks depending on the tube type and your child’s condition. In hospital, this feels very scary, but with the right training and support, it is absolutely manageable. The critical thing is to always have a trained intensive care nurse present for tube changes at home, to always have a smaller and a spare tube, including one size smaller and one the same size immediately available. Our nurses are trained to manage emergency tube changes at home, but they’re more importantly trained to prevent emergency tube changes at home.

Prevention is better than cure. We always want to make sure that it never comes to an emergency tracheostomy change because that is not an ideal scenario. Having said that, depending on your child, children can be very quick of pulling out their own tracheostomy or while they’re playing, it might come out accidentally. It’s a big risk and you need to be on your A game at all times to manage and monitor to prevent that a pediatric tracheostomy or pediatric stoma can close and collapse very quickly so you don’t have a lot of time to manage such an emergency, which is why I’m saying it’s much better to prevent an emergency than to cure an emergency.

3.  Humidification.

The tracheostomy bypasses the nose and throat, which normally warms and humidifies the air your child breathes. Without humidification, secretions dry out and block the tube, which is a life-threatening emergency. Your child will need either a heated humidifier with a ventilator and also a heat and moisture exchanger, an HME, also known as a Swedish nose for times when they’re breathing without the ventilator. This is not optional. It is absolutely essential.

You might also need a nebulizer kit and to have your child having a nebulizer, like a saline nebulizer depending on the condition, normal saline nebulizer, Ventolin nebulizer, Atrovent nebulizer, Pulmicort nebulizer, depending on your child’s condition.

Stoma care let’s talk about that. The skin around the tracheostomy stoma needs daily care. Cleaning with sterile water or saline, changing the dressings under the tracheostomy tube flanges, and checking for signs of skin breakdown, granulation tissue or infection. Our nurses do this as part of every single shift.

Let’s also talk about emergency management. Every family with a child on a tracheostomy at home needs a clear emergency management plan. The most critical emergency is an accidental decannulation, the tube coming out or a blocked tube. Both can happen suddenly. Both require immediate action. And again, our nursing team is immediately available with 24-hour nursing care. This is why we do not believe in models where a nurse checks in for a few hours and then leaves the family alone overnight.

1.  It’s not best practice.

2.  It’s not evidence-based practice. For example, if you go to our website at intensivecareathome.com and you look up the evidence-based Mechanical Home Ventilation Guidelines, it clearly says that mechanical home ventilation with or without a tracheostomy, and even tracheostomy care without ventilation, is only safe at home with 24-hour intensive care nurses that have a minimum of two years critical care nursing experience in a hospital, ideally with a postgraduate, all of those nurses ideally should have a postgraduate critical care nursing qualification.

Roughly 75% of our nurses have a postgraduate critical care nursing qualification because our approach here at Intensive Care at Home is that we provide 24-hour intensive care nursing at home, including overnight care for pediatric patients on ventilation with or without a tracheostomy. Our nurses are ICU trained and experienced in pediatric ICU, including airway management at airway emergencies. We are here when you need us the most.

Obviously, we also make sure that the funding is there, that we’re not just talking here about some theory. Like I said, we’ve been providing Intensive Care at Home in Australia since 2012, and we’ve delivered millions of hours of Intensive Care at Home nursing for adults and for children. So, there’s no other provider that is number one third party accredited for Intensive Care at Home nursing. No other provider has as much intellectual property and policies and procedures that make our concept safe. No other provider has employed as many ICU nurses as we have. We’re bringing hundreds of years of ICU nursing experience combined into the community.

So, in the next segment, we want to talk about home ventilation, machines monitoring and the 24-hour nursing. In the next segment, I want to educate families on the practicalities of home mechanical ventilation, and we are looking at the evidence-based Mechanical Home Ventilation Guidelines, which are best practice and best safe practice most of all. And we also look at issues such as what happens if you don’t have 24-hour nursing care. Unfortunately, I have some horror stories to share there as well.

Now let’s talk about home ventilation because for many of the families watching, this is the piece that feels the most overwhelming, having your child on a ventilator at home feels like an impossible thing to imagine. I want to help you see that it’s not only possible, I can genuinely give your child and your family quality of life that a long-term pediatric ICU admission simply cannot, and I can give that to you with our service here at Intensive Care at Home.

So, there are two main categories of ventilation we manage and support at home.

1.  Invasive mechanical ventilation via tracheostomy. This is full mechanical ventilation, a ventilator that breathes for your child or supports their breathing delivered through the tracheostomy tube. Common ventilators used at home include the Astral, the Trilogy, and the LTV series. They are sophisticated machines, but with trained nursing staff at home, they are entirely manageable outside of an ICU and a hospital environment. At intensivecareathome.com, our nurses are trained on all major pediatric home ventilators. They manage alarm responses, circuit changes, ventilator settings, monitoring and documentation. Everything you would expect in a pediatric ICU is delivered in your home with our intensive care nurses.

2.  We manage non-invasive ventilation such as BiPAP or CPAP. So, children also use non-invasive ventilation such as CPAP or BiPAP without a tracheostomy delivered by a mask for periods of time. That can also be done when a tracheostomy is capped. Most kits that use BiPAP or CPAP non-invasive ventilation do not have a tracheostomy, but both most of the time need 24-hour intensive care nurses as well because children on BiPAP or CPAP would also be in intensive care in a hospital.

Our nurses are experienced in managing CPAP and BiPAP in children at home, including mask fitting, leak management, and titration monitoring. Please also keep in mind, I mentioned a minute ago that we follow the evidence-based guidelines, which are the Mechanical home ventilation guidelines. Those guidelines are a result of over 25 years Intensive Care at Home nursing in Germany and Australia, and it has shown that this is best practice to have 24-hour intensive care nurses at home, cuts the cost of an ICU bed by 50%. It frees up an ICU bed. It brings you and your family and your child quality of life. It is a win-win situation.

So, let’s also talk about monitoring at home. When your child is on a ventilator at home, monitoring is critical. This typically includes continuous pulse oximetry, oxygen saturation monitoring, end-tidal CO2 monitoring where indicated, heart rate and respiratory rate monitoring, ventilator alarm systems, which our nurses respond to immediately, regular clinical assessments, chest sounds, work of breathing, color secretion management. Our nursing team documents all of this every shift and communicates regularly with your child’s respiratory and pediatric teams. You are not on your own. You have a clinical team with us.

Let’s also look at the 24/7 intensive care nursing model at home. I want to be very direct about this because I think it’s the most important thing I can say to parents who are considering home ventilation or home tracheostomy care for their child. A ventilated child with or without a tracheostomy cannot be left alone, not for a few hours, not overnight. The risks are too great. Tube displacement, ventilator disconnection, mucous plugging, desaturations, these things happen suddenly and they require an immediate clinical response.

Our model is genuine 24/7 intensive care nursing at home. That means an ICU or pediatric ICU-trained nurse is present in your home at all times during the day, through the night, seven days a week. This is not a call-out service. This is a genuine 24/7 intensive care nurse in your home every hour of every day. This model gives families something extraordinary, the ability to actually sleep, knowing your child is safe, the ability to have siblings, to have family life, to be parents rather than round-the-clock carers, the ability to give your child a home, not a hospital bed.

Here is what really makes us different. Every nurse in our pediatric team has extensive ICU and pediatric ICU training. We do not send general trained general nurses without ICU experience, let alone disability support workers to manage ventilated and tracheostomy children. Our clinical standards are hospital grade daily at home with compassion, with the difference that is needed for a home care environment.

If you want to know more about how this works practically, equipment staffing costs, NDIS funding, please go to our website at Intensive Care at Home and you can call me directly there if you want to talk to me or to one of our senior staff members, we are there for you. We want to talk to you and we want to understand your needs. We want to understand what your world looks like and how we can help you to the best of our ability. Every initial consultation is all free of charge. We want to understand you and help you create a tailor-made care model for you, for your child and for your family that works for you, with the staff that works for you.

I also need to mention here that without the incorrect level of funding, that unfortunately children have died at home. I’m not here to scare monger, but I’m also very realistic about what’s happening out there in the community. I’ve seen the good, the bad, and the ugly. My job here is to combine both intensive care in a hospital, which I’ve worked with for decades as well, and the intensive care in the community. Combine both, make it safe, get the right funding, get the right team structure for you as a client, and make it safe so that you and your child and your family can live the best possible life.

Unfortunately, children have died when there wasn’t 24-hour nursing care with critical care nurses, and unfortunately, I have plenty of evidence for that. So, everything that I’m saying here, I can back up with substantial evidence and that’s why I do this. We want to get things right for our clients and we want to make sure that our clients can live long and prosperous lives and that their families can live peaceful and prosperous lives.

So, let’s now look at NDIS support coordination because obviously funding needs to be navigated for your child as well. In this segment, I’m going to explain level 2 and level 3 NDIS support coordination. I’m going to demystify the process and position Intensive Care at Home as the expert provider because that is what we are. I also know that what I’m going to talk about now is that families tell us is one of the most confusing and frustrating parts of this whole journey, the NDIS, assuming that your child needs NDIS funding.

For most of you watching this, that will be the case. You would probably come in under NDIS. Some of you might come in under different funding bodies, including private health insurance, but most of you would probably be coming in under the NDIS because if you have a child with a tracheostomy, particularly a child who’s ventilator-dependent or who has a significant disability alongside their respiratory needs, there’s a very good chance that your child is eligible for NDIS funding. A lot of complex disabilities lead to respiratory issues, which means there will be NDIS funding as part of NDIS legislation. And NDIS funding can be the difference between your child staying in a pediatric ICU indefinitely at enormous cost to the healthcare system and enormous emotional cost to your family and to your child and your child coming home with a funded NDIS nursing support package.

Here’s also the truth about the NDIS. It is a complex system. The funding categories can be confusing, the planning meetings can be intimidating, lengthy, and if you don’t know how to advocate effectively, you can end up with a plan that doesn’t actually fund the level of support your child needs. This is exactly why we offer NDIS support coordination, both level 2 and level 3 specialist support coordination.

So, what is level 2 NDIS support coordination? Level 2 NDIS support coordination, simply called support coordination, helps you implement your NDIS plan. A NDIS support coordinator works with you to identify the right providers, connect services, build community linkages, and make sure your NDIS plan is being used effectively to support your child’s needs. If your child has a complex disability and is receiving care at home, this coordination role is absolutely critical.

What is NDIS level 3 specialist support coordination? Level 3 NDIS specialist support coordination is for participants with the most complex situations. This is funded when a participant’s support needs are so high or their circumstances are so complex that specialist clinical knowledge is required to coordinate their supports effectively. For a ventilated child with or without a tracheostomy, level 3 is often the appropriate level, and it is something we can help you apply for because we have level 2 and level 3 NDIS support coordinators on our books and in our network.

Our specialist NDIS support coordinators are very experienced and they have clinical backgrounds, and if they don’t have clinical backgrounds, they can get it from our team of intensive care nurses. They understand the medical complexity of your child’s situation. They can speak the language of hospital discharge teams, respiratory teams and NDIS planners, and they can advocate for your child’s needs in a way that a generic support coordinator simply cannot.

Through the NDIS, families can access funding for 24/7 intensive care nurses at home under the NDIS disability support and high intensity daily personal activity categories. Specialist support coordination level 2 and level 3, assistive technology, including some home ventilation equipment, home modifications where necessary, respite and carer support. We help families from the very beginning before your child’s first NDIS plan is even written, all the way through plan reviews and funding appeals. We know what good plans look like for ventilated children and we know how to help you to get there.

Here’s what’s really important. If your child is currently in the pediatric ICU and has not yet received an NDIS assessment, this process can and should start now before discharge. We strongly recommend engaging with NDIS as early as possible in the discharge planning process. We can help you do this. If you feel lost in the process, please reach out to us, again, at intensivecareathome.com. If you’re not sure whether your child is eligible for the NDIS or you already have a plan and you’re not sure if it’s adequate, please reach out to us. We offer an initial conversation at no cost and we can help you understand what’s possible.

So, like I said, I also want to mention that without the right funding, or if you think you can shortcut and have only 12 hours a day of nursing and not daytime or not nighttime, unfortunately many children and adults have died and we are tirelessly advocating for our clients so that this will never happen again. But you can’t shortcut here what needs to happen. What needs to happen in situations like that is you need 24-hour intensive care nursing, similar to an ICU. Or even if you are on a long-term weaning unit in a children’s hospital around the country, even you would’ve seen there that if you’re not there, someone needs to be with your child 24 hours a day, and that needs to be an airway competent nurse.

So, I hope that helps you understand. I hope that helps you clarify what is entailed to take your child home. And it can all be done. Do not be intimidated by any funding. Keep in mind that someone is paying for that ICU bed, and that costs between $5,000 to $10,000 per day. Let me repeat that. It costs between $5,000 to $10,000 per day in ICU. And we can do this at home for half the cost. So, the NDIS will have an interest in paying for it, assuming all the evidence is there, but we can help you with that. Do not let the hospital or anybody short-chain you because we’ve got enough experience and insights here that the funding is there.

So, I do want to wrap this up here now, and I also want to do a follow-up maybe next week or during the week. It might not be a live, but it might be a live if you’re at home already and you realize your level of support is not adequate, your level of support is risky, your level of support gets your child back to hospital all the time and you’re not feeling safe and you don’t have the funding, and I can walk you through how to take the next steps to make it safe, get 24-hour nursing care and get the funding.

So, that’s it for today. If there are any questions, please let me know right now. If there are no questions, I’m going to wrap this up now and I will talk to you again during the week with my quick tip videos or next week in another YouTube live.

Take care for now.

With all of that said, with Intensive Care at Home, we are currently sending our critical care nurses into the home 24 hours a day. Therefore, we are providing a genuine alternative to long-term stay in intensive care for:

• Ventilation
• Tracheostomy
• Home BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)
• Tracheostomy care without ventilation
• home TPN (Total Parenteral Nutrition)
• Home IV potassium
• Home IV magnesium
• Home IV antibiotics
• Home IV fluids

We’re providing:

• Cough assist management at home
• Ventilation weaning management at home
• central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line as well as port management at home
• nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home
• IDC (Indwelling Catheter) and SPC (Suprapubic Catheter) management at home
• Palliative care services at home

We’re 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 Health District’s In Touch program, saving approximately $2,000 per patient that we keep at home instead of them going into an emergency department.

That also means we’re in a position to cut the cost of an ICU bed by around 50%. An intensive care bed costs between $5,000 to $10,000 per bed day depending on location. Intensive Care at Home costs approximately 50% of that, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders.

Our Coverage and Accreditation

With Intensive Care at Home, we’re currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria as well as the Department of Veterans Affairs all around Australia.

We’re also ISO 9001:2015 accredited. Our clients and we as a service provider have also received funding through public hospitals, private health funds as well as departments of health.

We are 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 high level of accreditation since 2012. No other provider in Australia has achieved the Intensive Care at Home level of accreditation  in the community and has created more intellectual property when it comes to 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. And that enables us to look after the highest acuity adults and children in the community in Australia safely.

If You Need Help

If you’re at home already and you’re watching this or you’re stuck in an ICU and you realize that you don’t have the right level of support, I can give you many examples where we helped clients with funding, how we advocate for funding. We had to advocate successfully for funding from our first case study to many other case studies where we had to advocate successfully for funding with the right evidence of course because it is crystal clear that disability support workers for example or registered nurses without ICU experience cannot look after ventilated clients at home whether adults or children with or without a tracheostomy and it’s simply dangerous and negligent.

There are plenty of examples where clients with support worker models or even RN (registered nurse) models without ICU experience have died at home and I have evidence to back up everything that I’m saying here because it’s a bit like flying the airplane with a cabin crew instead of the pilot and it could simply be deadly.

This can be avoided by having simply 24-hour critical care nurses at home because our clients are at high risk of medical emergencies or worse without critical care nurses 24 hours. This is actually also evidence-based in the community and is documented in our evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com.

Think about it: in an intensive care unit in a hospital, you wouldn’t have support workers or general registered nurses looking after a critical care patient on a ventilator with a tracheostomy. So why would anyone in their right mind do that in a home care environment where there are fewer resources?

Clients that have found us have been at home long-term predictably and permanently with critical care nurses. Their alternative would have been to either die or stay in ICU long-term, and our clients don’t go back to ICU. They stay at home permanently and predictably and the insurance bodies save half of the cost of an ICU. But it’s a win-win situation all around.

We can do the same for you if you’re stuck in ICU or if you’re not safe at home, which includes the advocacy for funding and the network that goes along with it. We have always successfully advocated for our clients or we have the network to successfully advocate for you and for your family member, otherwise we wouldn’t be in business. The same again is applicable for those stuck in an ICU which is similar to many of our, if not most of our cases.

Our Support Coordination Services

This is also why we are providing Level 2 and Level 3 NDIS support coordination. We have a team of experienced NDIS support coordinators, and they have a wealth of knowledge. 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 or a social worker from another organization or a hospital 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 how to advocate for it, what evidence to provide, I encourage you to reach out to us as well. We have the network to make that happen. 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.

Join Our Team

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, successful, and high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined.

If you’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, Albury-Wodonga, Bendigo, Geelong, Warragul, and also in Wyelangta in Victoria.

If you have worked in critical care nursing for a minimum of two years, adult ICU, pediatric ICU, ED and you have already completed a postgraduate critical care nursing qualification, we will be absolutely delighted hearing from you.

I have a disclaimer though: Because we are offering tailor-made solutions for our clients which includes regular staff, our clients do also want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular, reliable staff.

If you’re looking for agency work where you can come and go, this will not be the right fit for you. We’re 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 you’re really keen on building relationships with us and with our clients. Reliability is also a must.

For Medical Professionals and Healthcare Executives

If you’re 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 to 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 so much more cost-effective than what you’re paying for in ICU and ED settings, and you get the same level of care and simply more patient and family satisfaction because you also want to partner with your consumers. If you are a hospital executive watching this, we can help you free up your ICU and ED beds.

International Support

If you’re in the U.S. or in the UK 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, click the like button, 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, and share this video with anyone who has a family member in intensive care long-term or needs to see this.

Thank you so much for watching.

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

Take care for now.