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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today I was talking to a client who’s had their 82-year old grandfather in intensive care and her grandfather has been in intensive care with a recurring pneumonia and a recurring pulmonary edema because of a weak heart with an ejection fraction of 22%.

So her grandfather has to be in and out of ICU in the last two months and he’s been intubated with a breathing tube then he’s been extubated again and now finally, the intensive care team has suggested to do a tracheostomy.

Now, as you’ve heard me say before, the biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care.

So whilst after multiple failed extubations and now after about 10 days back on the ventilator with the breathing tube, through the mouth, I would argue that a tracheostomy is the right next step because the intensive care team actually has tried beyond a shadow of a doubt to get my client’s grandfather off the ventilator with a breathing tube. But given that’s failed now a tracheostomy is definitely the next right step.

So where to from here? Well, after the tracheostomy, my client has asked whether intensive care at home is the right next step. Well, it really depends. Yes, going home with intensive care at home, if you’re on a ventilator with the tracheostomy and you can’t be weaned off the ventilator, or there is prolonged weaning, I would argue, yes, it’s the right next step.

But at this particular point in time, you would have to wait a few more days after the tracheostomy has been done to see if the grandfather can come off the ventilator and can also have the tracheostomy remove because going home without the ventilator and without the tracheostomy is so much easier.

You see, regardless of whether your grandfather is going home with the ventilator and the tracheostomy, or he’s going home only with the tracheostomy, your grandfather still needs 24-hour nursing care with ICU nurses because tracheostomy management is a specialized skill that can only be learned in intensive care after many years of training and after many years of experience.

So looking after your grandfather at home with the ventilator or with a tracheostomy can really only be done with a service like intensive care at home that sends intensive care nurses home 24 hours a day. So, but again, it’s too early.

The ideal scenario would be, get the trach done and then wean your grandfather off the ventilator in intensive care, and then send him home. Have the trach removed, have the ventilator removed, and then go home without the ventilator and the trach. Only if weaning off the ventilator and weaning off the tracheostomy fails after a couple of weeks, then you should look at intensive care at home.

So that is my quick tip for today.

If you have a loved one in intensive care and you need help, go and check out intensivecarehotline.com. Call us on one of the numbers on the top of our website, or send us an email to [email protected].

Like this video, comment down below what questions that you have and subscribe to my YouTube channel for updates for families in intensive care.

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