{"id":5536,"date":"2024-04-02T16:00:31","date_gmt":"2024-04-02T05:00:31","guid":{"rendered":"https:\/\/intensivecareathome.com\/?p=5536"},"modified":"2024-04-02T17:24:43","modified_gmt":"2024-04-02T06:24:43","slug":"how-can-my-9-month-old-baby-be-weaned-off-the-ventilator-tracheostomy-in-picu-can-she-go-home","status":"publish","type":"post","link":"https:\/\/intensivecareathome.com\/how-can-my-9-month-old-baby-be-weaned-off-the-ventilator-tracheostomy-in-picu-can-she-go-home\/","title":{"rendered":"How Can My 9-Month-Old Baby Be Weaned Off the Ventilator &#038; Tracheostomy in PICU? Can She Go Home?"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_6415\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-5536-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2024\/APRIL\/How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3?_=1\" \/><a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2024\/APRIL\/How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3\">https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2024\/APRIL\/How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2024\/APRIL\/How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/intensivecareathome.com\/?powerpress_pinw=5536-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2024\/APRIL\/How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"How+Can+My+9-Month-Old+Baby+Be+Weaned+Off+the+Ventilator+%26+Tracheostomy+in+PICU_+Can+She+Go+Home.mp3\">Download<\/a><\/p><p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/90JgIL5G-VQ?si=QnKreg670TU8nRKG\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>How Can My 9-Month-Old Baby Be Weaned Off the Ventilator &amp; Tracheostomy in PICU? Can She Go Home?<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-5537\" src=\"https:\/\/intensivecareathome.com\/wp-content\/uploads\/2024\/04\/Athome_1_How-Can-My-9-Month-Old-Baby-Be-Weaned-Off-the-Ventilator-Tracheostomy-in-PICU-Can-She-Go-Home-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/intensivecareathome.com\/wp-content\/uploads\/2024\/04\/Athome_1_How-Can-My-9-Month-Old-Baby-Be-Weaned-Off-the-Ventilator-Tracheostomy-in-PICU-Can-She-Go-Home-300x169.jpg 300w, https:\/\/intensivecareathome.com\/wp-content\/uploads\/2024\/04\/Athome_1_How-Can-My-9-Month-Old-Baby-Be-Weaned-Off-the-Ventilator-Tracheostomy-in-PICU-Can-She-Go-Home-768x432.jpg 768w, https:\/\/intensivecareathome.com\/wp-content\/uploads\/2024\/04\/Athome_1_How-Can-My-9-Month-Old-Baby-Be-Weaned-Off-the-Ventilator-Tracheostomy-in-PICU-Can-She-Go-Home.jpg 782w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><br \/>\nHi, it&#8217;s Patrik Hutzel from <strong>intensivecareathome.com<\/strong> 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 care for long-term ventilated adults and children with tracheostomies, otherwise medically complex adults and children at home, which includes <a href=\"https:\/\/intensivecareathome.com\/quality-life-nursing-services-adults-children-requiring-non-invasive-mask-ventilation-cpap-bipap-andor-high-flow-oxygen-therapy\/\" target=\"_blank\" rel=\"noopener\"><u>Home <\/u><u>BIPAP (bilevel positive airway pressure)<\/u><u>, Home <\/u><u>CPAP (continuous <\/u><u>positive airway pressure)<\/u><\/a>, also home tracheostomy care for adults and children that are not ventilated, also Home TPN, Home IV potassium infusions, Home IV magnesium infusions, Home IV antibiotics. We also provide port management, <a href=\"https:\/\/intensivecarehotline.com\/central-venous-lines\/\" target=\"_blank\" rel=\"noopener\"><u>central line<\/u><\/a>\u00a0management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman&#8217;s line management, as well as palliative care services at home.<\/p>\n<p>Now, in today&#8217;s blog post, I want to answer a question from Sonia. Let me read out the question from Sonia who says,<\/p>\n<p>\u201c<strong>Hi, Patrik<\/strong>,<\/p>\n<p>I have my nine-month-old baby girl in intensive care. She had four failed extubations. So, she had to have a <a href=\"https:\/\/intensivecarehotline.com\/tracheostomy\/\" target=\"_blank\" rel=\"noopener\"><u>tracheostomy<\/u><\/a>\u00a0and has been stuck on a <a href=\"https:\/\/intensivecarehotline.com\/ventilators-breathing-machines\/\" target=\"_blank\" rel=\"noopener\"><u>ventilator<\/u><\/a>\u00a0since May last year. Her respiratory rate has been high since birth. When she&#8217;s asleep, it&#8217;s between 50 to 60 breaths per minute, but when she&#8217;s awake, it&#8217;s anything between 70 to 90 breaths per minute. She currently has a PEEP of 10, and pressure control and pressure support of 6, respectively. Do you have any advice on how we are able to wean her off? She has no airway issues; CT scan was okay. The only thing that the doctor say is that her lung volume is less than a baby her age.\u201d Thank you so much, Sonia, for sending through this question.<\/p>\n<p>So well, first off, you need to establish what ventilation setting she is in. Is she in a controlled ventilation mode such as SIMV (Synchronized Intermittent Mandatory Ventilation) or ACV (Assist Control Ventilation) where the machine is delivering a set number of breaths per minute, or is she in a CPAP or pressure support ventilation mode where she&#8217;s triggering most of her breaths herself? Is she passing any spontaneous breathing trials? You haven&#8217;t elaborated on that. Has she been off the ventilator at all? Even if it&#8217;s only for 5 or for 10 minutes, even that would be a starting point.<\/p>\n<p>In terms of weaning your daughter off the ventilator, it should be similar. It&#8217;s not dissimilar to many other adult patients; mobilization, stopping <a href=\"https:\/\/intensivecarehotline.com\/sedation\/\" target=\"_blank\" rel=\"noopener\"><u>sedation<\/u><\/a>, stopping opiates. Mobilization would be first and foremost, reducing PEEP, reducing pressure support, reducing oxygen levels as much as you can and getting her to breathe on CPAP pressure support more and more. Once she can do that, more than 24 hours a day, put her on a T-piece and see what happens.<\/p>\n<p>Now, if that can&#8217;t be achieved, other strategies here could be lung volume is decreased. She could potentially have a tracheostomy. Many ICUs are doing that, do a bronchoscopy which is putting a video camera down in the lungs and see what&#8217;s going on there. Also, with lung volume being decreased, why is that? Is she having secretions? Why is lung volume decreased? Was she prematurely born? Are lungs affected, not developed? You haven&#8217;t elaborated on any of that, but those would be things that I would be asking them and see what the answers are.<\/p>\n<p>If your daughter cannot be weaned off the ventilator, then clearly the <strong>Intensive Care at Home<\/strong> is the best next step. She shouldn&#8217;t be in ICU for nine months, which is too long when you&#8217;re living there. You and your family are probably living there to be with her, and that&#8217;s not a good environment. So, she&#8217;d be much better off at home than in ICU in the long run if she can&#8217;t be weaned. Once she&#8217;s in her own home environment, maybe weaning would take place with a team of ICU professionals around that can facilitate the weaning in a much better patient and family environment, which is a home care environment, no question about that especially since it&#8217;s been nine months. I mean, that&#8217;s not a good environment to be in after nine months. You want your daughter to be at home, I&#8217;m sure you want to be around your family at home, and so forth.<\/p>\n<p>So, that would be my advice here, and if you do want your daughter at home, you should reach out to us here at <strong>intensivecareathome.com<\/strong>.<\/p>\n<p>Now, with <strong>Intensive Care at Home<\/strong>, we are currently operating all around Australia and in all regional rural areas and all major metropolitan areas. We are a NDIS (National Disability Insurance Scheme) accredited service provider.\u00a0 We are a TAC (Transport Accident Commission) approved service provider in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland. We are also DVA (Department of Veteran Affairs) approved all around Australia. We have received funding through public hospitals, private health funds as well as departments of health.<\/p>\n<p>We are also providing <a href=\"https:\/\/intensivecareathome.com\/ndis-specialist-support-coordination\/\" target=\"_blank\" rel=\"noopener\"><u>Level 2 and Level 3 NDIS Support Coordination<\/u><\/a>\u00a0which would be critical in a situation like that to get on the NDIS scheme.<\/p>\n<p>Now, also, what is very important to know is that we practice <strong>Intensive Care at Home<\/strong> according to the evidence-based <a href=\"https:\/\/intensivecareathome.com\/mechanical-home-ventilation-guidelines\/\" target=\"_blank\" rel=\"noopener\"><u>Mechanical Home Ventilation Guidelines<\/u><\/a>. I encourage you to have a look there because only we exclusively work with intensive care\/pediatric intensive care nurses with a minimum of two years pediatric intensive care or in adult intensive care experience, which puts us in a position where we employ hundreds of years of intensive care nursing experience in the community, which is unmatched. We are the only service provider in Australia that has <a href=\"https:\/\/intensivecareathome.com\/accreditationquality\/\" target=\"_blank\" rel=\"noopener\"><u>third party accreditation for <strong>Intensive Care at Home<\/strong><\/u><\/a>. No other service has built the accreditation and has built the intellectual property that we have built.<\/p>\n<p>We are also sending to our critical care nurses into people&#8217;s homes and into residential aged care facilities to avoid emergency department admissions (ED admissions) and <a href=\"https:\/\/intensivecareathome.com\/does-your-hospital-want-a-home-ed-emergency-department-bypass-service-and-improve-ed-access\/\" target=\"_blank\" rel=\"noopener\"><u>provide an emergency bypass service<\/u><\/a>. If your hospital is interested in doing the same for your ED, please reach out to us now.<\/p>\n<p>Also, if you are a NDIS Support Coordinator and you are looking for nursing care for one of your participants, please reach out to us, or if you don&#8217;t know how to go about getting nursing care through the NDIS or through other insurance schemes, please reach out to us.<\/p>\n<p>We have done most of the advocacy for our clients, we&#8217;ve been heavily involved, we\u2019ve written lots of reports and stuff, and we also do NDIS nursing assessments and other nursing assessments, specialist nursing assessments, in particular.<\/p>\n<p>If you are a critical care nurse and you have a minimum of two years critical care nursing experience, ideally with a postgraduate critical care qualification, we want to hear from you. We currently have jobs in Sydney, Melbourne, Brisbane, in Albury, Wodonga, in Bendigo, and in Warragul. So, we have a wide variety of job opportunities for critical care nurses that have the right mindset and have the right skills.<\/p>\n<p>Also, we are not an agency. We are a service provider that has a tailor-made solution for our clients, and we pride ourselves on that. That means if you are a critical care nurse interested in working with <strong>Intensive Care at Home<\/strong>, we&#8217;re really looking for a staff that can give us regular availabilities, that are reliable. Reliability is not negotiable at all. Our clients want regular staff, we want regular staff, and that&#8217;s why we have a tailor-made solution for our clients. We don&#8217;t have people that come and go, that doesn&#8217;t work for us. So, if you&#8217;re looking for agency work, please don&#8217;t come to us. We&#8217;re looking for reliable people that want to make a difference to our clients and their family&#8217;s life, and that want to build relationships with our clients, but also, with us as an organization, of course.<\/p>\n<p>Now, if you are at home already and you have insufficient support, or if you are in intensive care, similar to our reader here Sonia, who has the baby girl in intensive care, we can help you going home of course, or you and your family to go home. If you&#8217;re at home already and you have insufficient support, you have regular ICU readmissions, you have people coming and going that don&#8217;t know what to do with a tracheostomy or a ventilator.<\/p>\n<p>I was just in a meeting yesterday with a potential client who&#8217;s at home already. They said they have registered nurses who don&#8217;t know what to do with the tracheostomy. Well, there&#8217;s no surprise there because it takes an intensive care nurse or a critical care nurse to know how to handle a tracheostomy, either in ICU or at home, that&#8217;s why we are the specialist on tracheostomy and ventilator care at home.<\/p>\n<p>If you are an intensive care consultant and you&#8217;re looking for a career change, we are also currently expanding our medical team.<\/p>\n<p>If you&#8217;re an intensive care specialist, ICU consultant working in ICU, and you have bed blocks, which I know you do, we want to hear from you as well. We can help you eliminate and manage your bed blocks.<\/p>\n<p>If you&#8217;re a hospital executive watching this, we also want to hear from you because once again, I know you&#8217;ve got bed blocks in your hospital and in your ICU and in your ED, we can help you eliminate all of that and you don&#8217;t even pay for it. So, please reach out to us as well.<\/p>\n<p>All of that you get at <strong>intensivecareathome.com.<\/strong> Call us on one of the numbers on the top of our website or send us an email to <strong>info@intensivecareathome.com.<\/strong><\/p>\n<p>Lastly, if you are in the U.S. or in the U.K. and you need help, please reach out to us as well. We can help you privately.<\/p>\n<p>If you like my videos, subscribe to my <a href=\"https:\/\/www.youtube.com\/channel\/UCFMAw7gyY0cJxrDSTCYIEYA\" target=\"_blank\" rel=\"noopener\"><u>YouTube channel<\/u><\/a>\u00a0for regular updates for families with <strong>Intensive Care at Home <\/strong>and intensive care. Click the like button, click the notification bell, share the video with your friends and families, share it far and wide, and comment below what you want to see next or what questions and insights you have from this video.<\/p>\n<p>Thank you so much for watching.<\/p>\n<p>This is Patrik Hutzel from <strong>intensivecareathome.com<\/strong> and I&#8217;ll talk to you in a few days.<\/p>\n<p>Take care for now.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>: Play in new window | Download How Can My 9-Month-Old Baby Be Weaned Off the Ventilator &amp; Tracheostomy in<a class=\"read-more\" href=\"\">Continue Reading <i class=\"fa fa-angle-double-right\" aria-hidden=\"true\"><\/i><\/a><\/p>\n","protected":false},"author":5,"featured_media":5537,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[2],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How Can My 9-Month-Old Baby Be Weaned Off the Ventilator &amp; Tracheostomy in PICU? 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