Why 24/7 Critical Care Nurses are Essential for Tracheostomy Clients Without Ventilation?

“Why 24/7 critical care nurses are essential for tracheostomy clients without ventilation.”

My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies that are critically ill and are ventilated at home. We also provide Home TPN (Total Parenteral Nutrition), IV potassium, IV magnesium, IV antibiotics, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, central line management, port management at home, as well as cough assist management, nasogastric tube, PEG (Percutaneous Endoscopic Gastrostomy) tube management at home, just to name a few in the critical care arena at home.

So, let’s look at why 24/7 critical care nurses are absolutely essential for tracheostomy clients without ventilation at home.

Number 1, why a tracheostomy alone is life-threatening. Many people assume that if someone has a tracheostomy without being ventilated, they are “low risk.” That assumption is dangerous and completely false. The truth is simple: A tracheostomy is always a high-risk, unstable airway. Let me repeat that. A tracheostomy is always high-risk and unstable airway, full stop. It doesn’t matter whether that’s in a hospital, in ICU, or at home.

If a tracheostomy blocks or becomes dislodged, the person cannot breathe. Let me repeat that again, so it sinks in. If a tracheostomy blocks or becomes dislodged, the person cannot breathe. Within minutes, this can lead to cardiac arrest, hypoxic brain injury, or death. Let me repeat that again. Within minutes, a blocked tracheostomy or dislodged tracheostomy can lead to cardiac arrest, hypoxic brain injury or death.

Emergencies like this demand immediate intervention by critical care registered nurses (CCRNs), not support workers, not general registered nurses. This is not just my opinion, it’s backed up by both independent NDIS nursing assessments by other CCRNs and also by evidence-based clinical guidelines.

Let’s look at the independent NDIS nursing assessment, real case, real risk. Take the case of one of our clients, a 37-year-old lady living with tetraplegia and a permanent tracheostomy after a hypoxic brain injury. An independent NDIS nursing assessment from a critical care nurse made it very clear and crystal clear. The client’s tracheostomy requires suctioning, humidification, and inner cannula changes multiple times a day. The client is at constant risk of airway blockage or tube dislodgement, both life-threatening emergencies.

The assessment concluded that 24/7 nursing by critical care registered nurses is reasonable and necessary to keep the client safe, prevent ICU readmissions, and ultimately keep her alive. This kind of independent nursing assessment for the NDIS is powerful evidence for NDIS decision makers. It confirms that tracheostomy care, even without ventilation, is a high intensity, high risk support that only critical care nurses can safely provide.

Next, let’s look at evidence-based guidelines to support this as well. At Intensive Care at Home, we follow the evidence-based Mechanical Home Ventilation Guidelines developed over 25 years of Intensive Care at Home nursing experience in Germany and Australia. These guidelines are the gold standard of care for anyone with a tracheostomy or ventilation at home.

The guidelines state very clearly, a tracheostomy, ventilated or not, requires 24/7 care by critical care nurses with at least 2 years of ICU experience. Anything less than this standard places clients at significant risk of preventable complications, hospital readmissions, or death. You can read the full Mechanical Home Ventilation Guidelines by clicking on the link below this video in the written version of this blog.

So, why support workers or general nurses are simply not enough? The NDIS sometimes suggests support workers or general registered nurses could provide tracheostomy care. But in practice, this is unsafe and against best practice. If anyone has used support workers or general registered nurses and is watching this, your loved one might have died by having support workers or general registered nurses, because they didn’t know what to do during a medical emergency. Support workers do not have advanced airway management training. General nurses are not trained in ICU level emergencies.

In a tracheostomy emergency, waiting for an ambulance is not an option because every second counts, and there’s no guarantee that an ambulance crew actually knows what to do with the tracheostomy and the ventilator. That’s why exclusively 24/7 CCRN care meets both the clinical and legal standards of safety for tracheostomy clients.

Basically, with Intensive Care at Home, it’s all about quality of life at home backed by evidence, with proper 24-hour CCRNs support, clients, like our case study today, are safe from life-threatening tracheostomy complications, prevented from unnecessary ICU readmissions, able to enjoy life at home with their families, living with dignity and safety backed by evidence-based practice.

This is why Intensive Care at Home exists to provide ICU level safety at home and to give families peace of mind and quality of life.

If you have a loved one with a tracheostomy, ventilated or not, make sure their care is based on both independent NDIS nursing assessments by critical care registered nurses, and evidence-based guidelines. Anything less is unsafe and not acceptable.

I argue, Intensive Care at Home, is the only provider in Australia that actually follows best practice guidelines, as well as independent NDIS nursing assessment by other CCRNs.

If you need an NDIS nursing assessment, we can help you with that because we’ve got a network of independent CCRN nursing assessors. So, go and check out intensivecareathome.com. Call me on one of the numbers on the top of our website to discuss how we can help you to get the right funding and care.

Now, 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:

• Home care services for ventilated adults & children with tracheostomies with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning 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 Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also 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 costs between $2,500 to $3,000 per bed day, 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. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

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 work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. 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 having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia 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, 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 you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012, 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 not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a 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 dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is 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 your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing 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 need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

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

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, 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 do have a disclaimer though, 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 so vulnerable and so special. 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 you’re really keen on building solid relationships with us and with our clients.

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 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 so 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, or for 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. and 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].

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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.