Podcast: Play in new window | Download
Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults& Children with Tracheostomies and otherwise medically complex Patients by improving their Quality of life and where we also provide tailor made solutions to hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!
In the last blog I shared
WHEN IS THE RIGHT TIME TO LEAVE INTENSIVE CARE (ICU) AND USE INTENSIVE CARE AT HOME?
You can check out last week’s episode by clicking on the link here.
In this week’s blog, I want to answer another frequently asked question from our readers and clients and the question this week is
What is the survival rate after a tracheostomy?
Many families in Intensive Care come to us and they have this very question “What is the survival rate after a tracheostomy”?
They often come to us with this very question when their loved one is on a ventilator with a breathing tube/endotracheal tube and can’t be weaned off the ventilator.
If their loved one can’t be weaned off the ventilator and potentially needs a tracheostomy wanting this question answered only makes sense.
Other crucial questions that also need to be answered when your loved one potentially needs a tracheostomy are the following (click on the links)
You might have heard me saying this before on this blog and I say it again because it is so important to understand!
The most important goal for families in Intensive Care is to get their loved one off the ventilator and the breathing tube/endotracheal tube in the first place.
A tracheostomy has its time and its place but only after all efforts have been maximised to get your loved one off the ventilator and the breathing tube/endotracheal tube. This is also being referred to as extubation (removal of the breathing tube).
Here are some step by step instructions in how to get your loved one off the ventilator and the breathing tube/endotracheal tube (click on the link)
Now in case, you haven’t heard me mentioning this before, you also need to keep in mind that if a tracheostomy is the only valid option for your critically ill loved one in Intensive Care/ICU you need to keep in mind also that if you are in the United States, a tracheostomy is often a vehicle to get your loved one out of ICU into LTAC (long-term acute care facility), often also being referred to as a long-term weaning ventilation facility.
Now I can only warn you that you should never agree to have your loved one go into LTAC in the first place because the only place where ventilated Patients can safely be looked after is Intensive Care/ICU or INTENSIVE CARE AT HOME.
Why? Because in order to manage ventilation, tracheostomy and the weaning process you need ICU doctors and ICU nurses.
LTAC’s don’t provide the level of services your loved one needs with tracheostomy and ventilation and many Patients die in LTAC, that’s the unfortunate reality. A discharge into LTAC is also often happening prematurely in order to empty ICU beds without considering the clinical needs, because ICU beds are in high demand.
I have more information here why you should avoid LTAC’s or nursing homes or any other substandard care at all cost when it comes to ventilation and tracheostomy
Now that you have a good understanding about the territory of ventilation, breathing tube/endotracheal tube and tracheostomy now it’s time to look at our original question
What is the survival rate after a tracheostomy?
Here are some numbers and statistics from this website here
https://www.ncbi.nlm.nih.gov/pubmed/14718444
Hospital and long-term outcome after tracheostomy for respiratory failure
RESULTS:
Four hundred twenty-nine patients were studied. Hospital mortality was 19%. Only 57% of survivors were liberated from mechanical ventilation. At 100 days, 6 months, 1 year, and 2 years after discharge, 24%, 30%, 36%, and 42% of hospital survivors had died, respectively. Patients liberated from mechanical ventilation and having their tracheostomy tubes decannulated had the lowest mortality (8% at 1 year); the mortality of ventilator-dependent patients was highest (57%). Sixty-six patients completed the SF-36 for functional status. While emotional health was generally good, physical function was quite limited.
Here is also a link to another study which suggests fairly similar results and outcomes for Patients with tracheostomy after respiratory failure
https://pdfs.semanticscholar.org/cd26/a70d335cfcc95c1cbcf436d1fe00cba7afd3.pdf
Now, what does that actually mean? Let me explain and break it down for you.
If 57% of survivors were liberated from mechanical ventilation it doesn’t actually say what happened to the tracheostomy.
What do I mean by that?
Many Patients might actually be liberated from mechanical ventilation and yet they still need the tracheostomy. Why do they still need the tracheostomy?
They need the tracheostomy for secretion management, swallowing difficulties and therefore aspiration Pneumonia risk and many other issues.
Again, here is more information regarding tracheostomy and if it can be reversed
Also, if a tracheostomy can’t be reversed and you or your loved one want to go home, the best next step is to engage a service like INTENSIVE CARE AT HOME so the tracheostomy can be safely managed at home and keep you or your loved one out of hospital
Next, if some Patients on a ventilator and tracheostomy are unable to be weaned off mechanical ventilation and the tracheostomy or if they take a lot longer than anticipated, rather than staying in Intensive Care/ICU long-term or even worse going to LTAC (long-term acute care facility), the best option for long-term ventilation with tracheostomy is for your loved one to go home with a service like INTENSIVE CARE AT HOME.
INTENSIVE CARE AT HOME brings Intensive Care skills, including ventilator and tracheostomy competent nurses into the comfort of your own home 24/7.
This creates a win-win situation
- It improves the quality of life for your loved one and for you as a family. Finally you and your loved one can go home and relax, because you have the professionals where you need them
- It frees up bed capacity in Intensive Care/ICU
- It reduces the cost of an Intensive Care/ICU bed by 50%
- Either long-term mechanical ventilation with tracheostomy at home is possible
- Ventilation weaning at home is possible
The list of the advantages of going home with INTENSIVE CARE AT HOME is incomplete but you get the idea!
Everybody is winning with INTENSIVE CARE AT HOME services.
Next, some Patients on ventilation with tracheostomy during prolonged mechanical ventilation approach their end of life unfortunately.
But rather than prematurely withdrawing treatment or “pulling the plug”, you still want your loved one to live!
Therefore, you and your family can also use a professional service like INTENSIVE CARE AT HOME for end of life care and palliative care at home rather than end of life care in a sterile hospital environment!
Did you know that 75% of the population in developed countries want to die at home and yet only 14% actually do die at home?
INTENSIVE CARE AT HOME enables long-term ventilated Patients with tracheostomy to approach their end of life at home!
Again this achieves the following advantages and creates a win-win situation
- It improves the quality of end of life for your loved one and for you as a family. Finally you and your loved one can go home and relax, because you have the professionals where you need them
- It frees up bed capacity in Intensive Care/ICU
- It reduces the cost of an Intensive Care/ICU bed by 50%
- It creates peace and harmony when you need it the most in the comfort of your own home!
The list of the advantages of going home with INTENSIVE CARE AT HOME is incomplete but you get the idea!
INTENSIVE CARE AT HOME services are available for both adults& children and you can see the full list of service offerings here
You can also read our case studies here
https://intensivecareathome.com/case-studies/
Warm Regards
Patrik Hutzel
If you want to find out how we can help you to get your loved one out of Intensive Care including palliative care or Long-term acute care (also nursing home) or if you find that you have insufficient support for your loved one at home on a ventilator, if you want to know how to get funding for our service or if you have any questions please send me an email to [email protected] or call on one of the numbers below.
Australia/New Zealand +61 41 094 2230
USA/Canada +1 415-915-0090
UK/Ireland +44 118 324 3018
Also, check out our careers section here
www.intensivecareathome.com/careers
We are currently hiring ICU/PICU nurses for clients in Melbourne, Sunbury and in South Gippsland/Victoria.
We are an NDIS, TAC (Victoria) and DVA (Department of Veteran affairs) approved community service provider in Australia.
We have also been part of the Royal Melbourne health accelerator program for innovative health care companies last year!
https://www.thermh.org.au/news/innovation-funding-announced-melbourne-health-accelerator
https://www.melbournehealthaccelerator.com/
Thank you for tuning into this week’s blog.
This is Patrik Hutzel from INTENSIVE CARE AT HOME and I see you again next week in another update!
THE 7 ANSWERS TO THE 7 MOST FREQUENTLY ASKED QUESTIONS IF YOUR LOVED ONE REQUIRES VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE/LTAC!
We hate spam too. Your privacy will be protected.
RELATED LINKS:
How can we improve the Quality of Life for long term ventilated Adults& Children with Tracheostomy and their Families outside of Intensive Care?
How much longer does my son need to stay in Intensive Care with Guillain-Barré Syndrome?
6 things NOBODY HAS EVER TOLD YOU about long-term ventilation with Tracheostomy at home!
Federal judge says: State must get ‘vent kids’ home!
Intensive Care at Home: An Opportunity or Threat?
