Quick Tip for Families in Intensive Care: My Sister in LTAC (Long-Term Acute Care) Has Sepsis from an Infected Dialysis Catheter. Does She Need to Go Back to ICU?

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

So, one of our clients has their 61-year-old sister in LTAC and she had a cardiac arrest earlier in the year and ended up with a tracheostomy and a ventilator. Now, she’s now in LTAC. A couple of weeks ago, she became very close to coming off the ventilator and apparently even her tracheostomy got capped and then she ended up with pneumonia and she went backwards.

Now, the sister says, nothing has happened from there. They still can’t cure the pneumonia and she’s been lying in bed ever since. She thinks that the LTAC is trying to hold on to her sister to make some money instead of doing what is right for patients, which is to get them off the ventilator and get them out as quickly as possible.

Now, obviously, if you’re wondering what’s an LTAC, LTAC stands for long-term acute care hospital, and it is very specific to the U.S. market. LTACs only exist in the United States. As of 2024, LTACs are designed to take critically ill patients out of intensive care with a ventilator, tracheostomy, and often with a PEG (Percutaneous Endoscopic Gastrostomy tube). We strictly advise against the PEG tube. The nasogastric tube will be perfectly fine, but I’ve made countless videos about that. So, you can go to our website intensivecarehotline.com and you can check out more there.

So, we also strictly advise against LTAC. Never ever let your critically ill loved one from ICU go to LTAC if you’re in the United States. So, let me read out the email from our client and see what she says further with her sister, what’s happening there now in LTAC.

“Hi Patrik,

So, my sister now has an infection in her bloodstream. That’s also known as the sepsis. They want chest catheter that was placed for dialysis, which is no longer needed, removed. Also want her PICC (Peripherally Inserted Central Catheter) line removed and replaced with a midline. The PICC line replacement may happen today. The catheter removal must be done in a hospital and may take a few days to schedule. Do you think it is safe/dangerous to wait a few days since she does have the bloodstream infection? Should we try to get her back to ICU? They’re saying here in LTAC that 911 won’t take her.

She is on vancomycin, cefepime, meropenem.”

So, this is what happens when critically ill patients go to LTAC prematurely and unnecessarily. They are often faced with so many challenges when they come out of ICU that LTAC simply don’t know how to deal with it.

Now, she has a bloodstream infection from the dialysis catheter, that means the LTAC doesn’t have the skills to keep the catheter site clean and free of infection, which should tell you everything that you need to know about an LTAC. I encourage you to look up LTAC reviews on Google, just type in your local LTAC if you’re in the U.S. and find out what families say about the LTAC. Read it and then you will understand why I’m saying do not let your loved one go to LTAC if you are in the United States, full stop.

So, should she be going back to a hospital? Absolutely, she should. We also have clients over the years to go from LTAC back to ICU. Now, here is another word of warning because we’re saying, do not let your loved one go to LTAC under any circumstances. We have seen that when patients go from ICU to LTAC, they often bounce back within 24 or 72 hours back to ICU, and then they often bounce back to another ICU because the ICU where the patient got discharged from no longer has a bed available. You will also find that some ICUs want to send your loved one to an LTAC hours away, sometimes to a different state, four hours away, six hours away. I’ve seen people going from Tennessee up to Massachusetts to Ohio. Crazy, crazy situations that I’ve seen over the many years that we’ve been consulting and advocating, and it just doesn’t make any sense.

So, put your foot down from Day 1 when you have your loved one critically ill in intensive care, make sure they’re not going to LTAC. There are proven strategies to prevent your critically ill loved one going from ICU to LTAC. We’ve helped many families preventing them from going to LTAC. One of the ways to manage that is do not give consent to a PEG tube, if a tracheostomy is necessary.

Go and get a second opinion anyway, we can give you that second opinion here at intensivecarehotline.com because you can’t just follow blindly. This is a once in a lifetime situation that you simply can’t afford to get wrong. You cannot afford to get that situation wrong. Therefore, you need a second opinion from Day 1, you need someone to guide you, and you need someone to handhold you through this once in a lifetime situation that you simply can’t afford to get wrong.

So, to answer your question, and this is our client – Dina, yes, you should take your sister back to ICU, back to hospital where she can actually get proper care and treatment and where they can wean her off the ventilator for once and for all, rather than putting her in an LTAC where they don’t know what they’re doing.

I have worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can say without the slightest hint of exaggeration that we have saved many lives here at intensivecarehotline.com.

You can verify that when you go to intensivecarehotline.com, have a look at our testimonial section or have a listen to our intensivecarehotline.com podcast where we interviewed clients and have a listen to what our clients are saying about the work that we’ve done for their families.

That’s why we created a membership for families of critically ill patients in intensive care and you can become a member if you go to intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org  directly. In the membership, you have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all questions intensive care related. In the membership, you have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded helping you making sure that you make informed decisions, have peace of mind, control, power, and influence so that you can impact decision making fast, so that your loved one gets best care and treatment.

I also do one-on one-consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I handhold you through this, once again, once in a lifetime situation that you can’t afford to get wrong. I show you what to do. I show you what questions to ask. I’ll show you how to manage doctors and nurses in intensive care and how to manage intensive care teams. I also talk to doctors and nurses directly on your behalf if you want me to do that, and I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get 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] with your questions.

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Now, thank you so much for watching.

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

Take care for now.