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

So currently we are working with a client who has their 79-year-old mom in ICU. She initially got admitted with severe pneumonia and ended up on a ventilator with a breathing tube initially, then had to have a tracheostomy because of the inability to get off the ventilator. And thankfully after a few days of the tracheostomy, she got off the ventilator. I made another video about this just a few days ago where the headline is something like, my mom came off the ventilator in record time. And that’s what a tracheostomy should be there for. It should facilitate ventilator weaning in record times. Really, once someone has a tracheostomy, sedation can be switched off and then hopefully, ventilator weaning can be started. And this particular lady came off the ventilator within just a few days.

So, in the meantime, the ICU keeps pushing for LTAC, and in the meantime they’re downsizing the tracheostomy, which means they’re now downsizing from a size 8 tracheostomy to a size 6, and she’s been off the ventilator for more than three or four days. So, the signs are pretty good for this lady to become decannulated, have the tracheostomy removed, then go on to a hospital floor or to a hospital ward, and then go home. And that’s what the lady wants. That’s what the family wants. And ICU keeps throwing in the curve ball to go to LTAC. Again, this is for our U.S. audience. There’s only really LTACs in the US. No other countries have any LTACs, but where am I going with this?

There is no need for LTAC. LTAC implies long-term acute care. It implies that someone needs long-term acute care. Well, there are some patients that may need long-term acute care, but this particular lady needs short-term acute care in ICU to get off the ventilator. And the ICU’s done a great job to get her off the ventilator, and now they need to focus on getting her decannulated and have the tracheostomy removed so she can make progress and can recover so she can go home. Why would you take a detour to a long-term acute care facility? Especially since this lady has only been in ICU since the 1st of April. The time of the recording of this video is the 14th of April. Medicare pays for up to 60 days in ICU anyway. What’s the urgency here? There should be no urgency at all. The urgency should be around getting the tracheostomy removed and then going home.

And this is also why we keep saying over and over again, do not give consent to a PEG tube. This lady has got a PEG tube. The family gave consent before they actually found intensivecarehotline.com, and we advised them that they should not have given consent to a PEG tube because LTAC does not take patients without a PEG (Percutaneous Endoscopic Gastrostomy) tube.

So, if you’re watching this and you’re wondering whether you should give consent to a PEG tube, the answer is no, because once your loved one has a tracheostomy and a PEG, they can go to LTAC. We strictly advise against LTAC. LTACs are not equipped or designed to look after ICU patients. Look at the online reviews of LTACs. There’s enough said on those online reviews. Look them up. Your loved one would be going from ICU, from a 1:1 or 1:2 nurse to patient ratio, to LTAC, which is a 1:5, or sometimes 1:10, nurse to patient ratio. They’re setting patients up to fail. They’re setting patients up to bounce back into ICU very quickly once they’re in LTAC.

And especially here, the momentum is on our client’s side. The momentum is clearly there. Why would they disrupt a positive care episode that most likely will have a good outcome? That is insanity in my mind. The care team there seems to be pretty good. They’re pretty committed. They can move this lady from A to B. Why would they outsource care to another facility if she’s so close to being short-term and not long-term acute care, and manage it in the hospital and then go home.

So that is my quick tip for today.

If you are in a similar situation, or if you have a loved one in intensive care, go to intensivecarehotline.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 a membership area or via email. And we answer all questions intensive care related 24 hours a day via email or in a membership area.

If you need a medical record review, please let us know as well. We review medical records in real time for families in intensive care. And we also review medical records after intensive care, but we strongly advise to get access to medical records while your loved one is in intensive care. Families don’t know what they don’t know. And unless you have someone professional that can interpret clinical data in intensive care in real time, the intensive care team can play yo-yo with you. They can tell you whatever they want, and you have no avenue to verify what they’re saying is true unless you can get that second opinion. And we can give you that second opinion by either talking to the doctors and nurses directly or by looking at medical records in real time.

Now, that’s my quick tip for today.

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, or what questions and insights you have from this video.

Thanks for watching.

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

Take care.