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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So yesterday, one of our clients reached out and said that his mom from LTAC (long term acute care) had to go back to intensive care. Now, this was after a reasonably short intensive care stay a few weeks ago where we thought, at the time, she was being discharged prematurely. And as you’ve heard me say before, no one should ever go to LTAC on ventilator and a tracheostomy to begin with, as the safest place for those patients is either intensive care or Intensive Care at Home. Those are the safest places for those patients.
Anyway, cutting a long story short, after about two weeks in LTAC, the lady has been readmitted to intensive care. Most likely with a GI bleed or a stomach bleed, most likely with a pneumonia. Potentially, she aspirated and she’s now back on antibiotics. She was back on inotropes and vasopressors, and she’s got a high white cell count and low hemoglobin. So, she needs blood transfusions. She needed inotropes and vasopressors. She needs IV antibiotics. And the ICU now needs to do a septic work up, which is basically to check for bacteria in the sputum, in the urine, as well as in the blood to find out where the infection is.
Now, here is the issue. And we’ve said it many times here that when someone gets discharged from ICU to LTAC, while they’re extremely vulnerable, they’re going from ICU basically to the better version of a nursing home, that’s what LTAC is. And then within a couple of weeks, they’re bouncing back into an ICU.
Now, the trouble here is that the ICU this lady bounced back to is a different ICU. So now, someone who’s already critically ill is going from one ICU to an LTAC and then to another ICU within about three weeks or four weeks’ time. That is madness in my mind. Critically ill patients need a stable team around them so that they can recover. The team gets to know them and that they can work with them consistently and move from admission to recovery.
Now, imagine you are critically ill and you’re bouncing around from facility or from hospital to facility, and then back to hospital. That is not in the best interest of a patient. It’s system designed, it’s system failure, I believe, and there must be better ways. The better ways are to keep patients in ICU longer until they’re weaned off the ventilator, and then they can go on to rehab and not to LTAC.
Anyway, that is my quick tip for today.
Do not discharge to LTAC if you can avoid it. If you need help with that, you should reach out to us here at intensivecarehotline.com.
Or if you have a loved one in intensive care, whether you want to avoid LTAC or whether you have other questions while your loved one is in intensive care, please contact us at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected]vecarehotline.com 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, and we answer all questions intensive care related, 24 hours a day, in a membership area and via email.
And if you do need a medical record review, you should contact us as well. We review medical records in real time while your loved one is in ICU. That is absolutely the preferred option because then we can interpret clinical data in real time and can break it down to you so that you can understand what’s really happening. But we also review medical records after intensive care if you suspect medical negligence.
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Thanks for watching.
This is Patrik Hutzel from intensivecarhotline.com and I will talk to you in a few days.