Can My Loved One in ICU Have a Tracheostomy After Cardiac Arrest&Go Home with INTENSIVE CARE AT HOME

https://intensivecareathome.com/can-my-loved-one-in-icu-have-a-tracheostomy-after-cardiac-arrest-go-home-with-intensive-care-at-home/

Can My Loved One in ICU Have a Tracheostomy After Cardiac Arrest & Go Home with INTENSIVE CARE AT HOME?

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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 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 adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition), and home IV potassium infusions, home IV magnesium infusions as well as 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’re also sending our critical care nurses into the home for emergency department bypass services to keep ED beds empty. We have done so successfully in the past for the Western Sydney Local Area Health District, their in-touch program.

Today, I wanted to talk more about our advocacy and also where it actually starts for our clients and their families. So, for example, currently, we have an inquiry of a patient in an ICU in Australia, which is where we are based. The client in ICU is a young patient who has a hypoxic brain injury after an out of hospital cardiac arrest and now, ICU says they wanted to withdraw treatment on the patient whereas the family has reached out to us and said, “Could he have a tracheostomy and could he go home with a tracheostomy?” The ICU keeps saying that it wouldn’t be “in the patient’s best interest” to have a tracheostomy and that it wouldn’t be ethical and that they should be proceeding towards end of life and withdrawing treatment.

Now, from my perspective, I have worked in critical care nursing for nearly 25 years in three different countries where I have also worked as a nurse manager for over 5 years. I was part of setting up Intensive Care at Home in Germany in the early 2000s, and I’ve been setting it up here in Australia, it’s been one of my frustrations and it’s been one of those frustrations from many families in intensive care that families are being told to “withdraw treatment,” and that would be ethical. But prolonging life with the tracheostomy is not ethical, so it would be more ethical to let someone die. I’ve yet to find where the ethics are in that, especially when it comes to young people in particular, but even young or old, it all comes down to patient and family choice and nothing else.

So, here is really where our advocacy starts. We have successfully advocated for tracheostomies in intensive care for our clients and especially now, in 2024, and for many years now, the NDIS (National Disability Insurance Scheme) is funding nursing care up to 24-hour nursing care, which means the NDIS can help free up ICU beds with our service, for example, Intensive Care at Home.

An ICU bed costs around $5000 per bed day, Intensive Care at Home is approximately 50% of that. With all of that said, the ICU also needs an empty bed, which is often where ICUs are basing their recommendations in this situation.

Continue reading at: https://intensivecareathome.com/can-my-loved-one-in-icu-have-a-tracheostomy-after-cardiac-arrest-go-home-with-intensive-care-at-home/