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

Today’s quick tip is in regards to tracheostomies for someone that is not on a ventilator with a risk for aspiration because they are unable to swallow. So, the reason I’m recording this video is that we are working with a client currently who has their loved one in LTAC in the U.S. As I have been saying over and over again for the last 10 years, LTACs are unsafe to look after ventilated or tracheostomy patients. I think I’ve got more evidence for that today because of what our client is experiencing currently with their father in LTAC (Long Term Acute Care).

So, here’s the situation. Their father managed to get off the ventilator but still needs a tracheostomy.  Apparently, he did not pass the swallow test and therefore, he’s at risk for aspiration. So then, when consulting with the client, I said, “Okay, well, if he’s at risk of aspiration, what tracheostomy does he have?” And the client said that her dad has a size 6 tracheostomy with a cuff.” So then, I said, “Well, so therefore, the cuff must be up” because she said, “Well, sometimes he’s also using the speaking valve in order to say a few words or a few sentences.” Well, here’s the bottom line. If someone is at risk of aspiration because they can’t swallow, the cuff needs to be up.

Now, let me illustrate that, and therefore, I actually show you a tracheostomy in this video. Hopefully, I can show it to you. There it is. So, I brought a tracheostomy so I can illustrate that to you.

So here is the tracheostomy. You can see at the tip, there’s the balloon. So, let me show this to you. If this is the trachea and the tracheostomy sits there. If the cuff is down and here is the mouth. If the cuff is down and someone swallows and the cuff is down, they will aspirate, and it will trigger an aspiration pneumonia.  So, therefore, for anyone that’s off the ventilator but has swallowing issues, the cuff needs to be up.

So let me show you this, I’ll just put the cuff up. So, you can actually see what’s happening next. So, you can see when I’m inflating the cuff, now the cuff goes up and that will stop a patient from aspirating if they have excess saliva and all patients do have that.

So, there’s also research out there to illustrate what I’m saying. I will link the research below this video that anyone who has a tracheostomy but can’t swallow needs the cuff up. Otherwise, they’ll be ending up on the ventilator again because they end up with aspiration pneumonia.

Again, to confirm what I’m saying, I will attach a research paper to this video so you can actually see what the research about that is. But then again, it confirms everything that I’ve been saying for the last 10 years about LTACs in the U.S. that they’re not equipped to look after patients with a tracheostomy or a ventilator. They don’t even know the mechanics around a tracheostomy.

Also, to illustrate this even more, with our service Intensive Care at Home, we are looking after patients at home with a tracheostomy as well. If patients have swallowing issues and they are not ventilated, they always have tracheostomy with a cuff and that cuff needs to be up at all times.

The exception here is for pediatrics, for children. Pediatric tracheotomies don’t have a cuff and the airway is sealed anyway because children have a much narrower airway. So, that is the exception. But for adults with swallowing issues, they always need to have a cuffed tracheostomy, just as I showed you a minute ago.

If you are looking for Intensive Care at Home services because you have a tracheostomy or you are on a ventilator, you should be going to intensivecareathome.com for more information. There, we are currently serving all capital cities and all regional and remote areas in Australia. You should be going to intensivecareathome.com for more information. We are also coming to the U.S. very soon, go and check out intensivecareathome.com.

That is my quick tip for today.

If you have a loved one in intensive care, go to intensive carehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in the membership area and via emails and we answer all questions, intensive care and Intensive Care at Home related.

I also provide one-to-one consulting and advocacy for families in intensive care. I talk to doctors and nurses directly. I can also represent you in family meetings, for example.

Again, if you need long-term care at home for a tracheostomy ventilation, or long-term ICU, please go to intensivecareathome.com and find more information there.

If you need a medical record review in real-time. If you have a loved one in intensive care and you want a second opinion in real time, please contact us as well. We also provide medical record reviews after intensive care especially if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence. Please contact us as well.

Now, subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next and what questions and insights you have from this video.

Thanks for watching.

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

Take care.