Hi there!

Today’s article is about, “Quick Tip for Families in Intensive Care: My Husband Has Gone to Step-Down ICU with Tracheostomy, Ventilation & Nasogastric Tube. Can He Go Home?”

You may also watch this through this YouTube link https://youtu.be/LBAuXKJiSkM or you can continue reading the article below.

Quick Tip for Families in Intensive Care: My Husband Has Gone to Step-Down ICU with Tracheostomy, Ventilation & Nasogastric Tube. Can He Go Home?

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

We have a membership for families of critically ill patients in intensive care that you can get access to when you go to intensivecarehotline.com and you click on the membership link, or you go to intensivecaresupport.org directly.

Today, I want to answer another question from one of our members who has been a member with us for the last few months. So, if you want to become a member and you want your questions to be answered, anything that is intensive care related, we welcome you into our membership as well

.

Without further ado, let’s read out the question from our member and I have made other videos in the last few days about this member, but it’s carrying on from a few other videos in the last few days.

“Hi Patrik and Team,

My husband is back in the step-down ICU and doing well. I think it was planned to put him in the ICU ward for the three days so that his adult kids could see him. The doctors pretended he was really ill, and he was sent back to the step-down ICU on Monday evening.

A lot is going on in this hospital.

Please assist me and my husband to go home. My husband has been here since July 18th. Case managers keep dragging their feet. They don’t play fair. He’s stable, alert, and responsive. He sat up in bed yesterday to do physical therapy, still a little bit weak but getting there. The doctor still tries and asks him if he wants PEG (Percutaneous Endoscopic Gastrostomy) and goes to LTAC (Long Term Acute Care). He has Stage 4 pressure sores.

The speech therapist doesn’t work with him as often as they should. They’re holding back his progress. He’s tolerating the bolus feeds really well, getting 240 mls 4x a day.

Thank you so much for your help.”

Now, this is actually a client who went home earlier in the year by themselves with the tracheostomy and the nasogastric tube. And as I have said in previous videos, that is actually really, really dangerous, right? And here is why.

Nasogastric tube is fine in ICU, but going home on nasogastric tube is dangerous unless you have a service like Intensive Care at Home. And you can find more information at intensivecareathome.com.

With Intensive Care at Home, we are sending critical care nurses into the home to take long-term ventilated and tracheostomy clients home from ICU, adults and children. And if they do go home with a ventilator and the trach with ICU nurses 24 hours a day, they could be okay with a nasogastric tube. But even then, the PEG is safer.

Please do not mix up with me saying don’t have a PEG tube to avoid LTAC by mixing it up with, if your loved one can’t come off the ventilator in the trach, beyond the shadow of a doubt, then the PEG tube is most likely the best next thing to do. You just can’t rush it in the beginning by any means, right? Do not rush a PEG tube in the beginning. There’s plenty of time to do a PEG tube. The priority when your loved one is in ICU on a ventilator with the trach the priority should be to wean them off the ventilator.

Now, when they have a PEG tube or if they get a PEG tube instead of a nasogastric tube, there is this perception in hospitals about the permanent PEG tube. And that gives health professionals the perception this person will never eat and drink again. And that is often the case. However, it gives almost all people a way out to not even try.

Whereas, with the nasogastric tube, it has the perception of it’s temporary. And if something is temporary, Plan A needs to be established, which means people have to eat and drink again tonight to take the nasogastric tube out. That is often not the case with the PEG tube.

However, if your loved one is going home with the nasogastric tube with the tracheostomy/ ventilator, they most likely will need a PEG tube, but you should not rush into it before your loved one ends up in LTAC, especially if you are in the U.S. But even if you’re in the U.K., in Australia and any other country do not rush PEG tube.

And again, in this case, coming back to our member’s question or original question, please help me to get home. Yeah, but you’ve been home before without any nursing support and with a nasogastric tube and your husband ended up back in ICU within a few days, just as we predicted at the time. It takes intensive care nurses 24-hours a day at home to make it safe and replicate the Intensive Care at Home. He bounced back into ICU in no time.

So, if you are in a similar situation and you want to go home, please contact us at intensivecareathome.com and we can guide you from there. With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas as well. So please contact us. But even if you’re in the U.K. and in the U.S., we can guide you have to find other providers potentially in other regions in the U.S., in the U.K. Please contact us one way or another.

Now, coming back to our member’s questions as the case manager, keep dragging their feet. They don’t play fair.

Well, I always feel like when people say that life isn’t fair, I agree with that, but the sooner you can actually make peace with that, the quicker you can actually move on and deal with things that are at hand.

I don’t get emotionally involved thinking that life isn’t that. That’s just a fact of life, but I don’t get emotionally involved in it because it doesn’t serve me. And I don’t think it serves you by getting emotionally involved in that life isn’t fair. Use that to your advantage and play by your rules. Turn it all around.

Now, it’s good that he’s stable, alert, and responsive and it’s good that he’s sitting up yesterday to do physical therapy. That’s really great. And the doctors keep asking him if he wants a PEG and go to LTAC. Of course, he doesn’t want to go to LTAC. Your way forward here is Intensive Care at Home. That is your way forward.

Now, the speech therapist doesn’t work with him as often as they should. Again, keep the pressure on, maybe make a formal complaint to the hospital executive. That’s what I would recommend because they are, like you said, holding back his progress. It’s good that he’s now finally tolerating the bolus feeds. That is really good.

It just took a little bit of fine tuning, and a few attempts to get it all right. And this is also so important when it comes to long-term, chronically ill patients. Getting it right and looking after them in the way that works for them, and not having the one size fits all approach is also very important. We know that from our Intensive Care at Home clients, having the right team, having the nuances worked out, having the routine worked out for the times is so important and you don’t get that in the hospital. I really encourage you to check out intensivecareathome.com.

So, this is what you get in the membership if want to have your questions answered anything intensive care related. That’s what we are there for.

Now, again, if you want to become a member of the intensive care hotline membership for families of critically ill patients in intensive care, go to intensivecarehotline.com, click on the membership link or go to intensivecaresupport.org directly. In the membership, you have access to me and my team 24 hours a day in the membership area and via email and we answer all questions intensive care related.

I also offer 1:1 phone, Zoom, WhatsApp, Skype, consulting, whichever medium works best for you. One on one with you and your families. I talk to doctors and nurses directly and ask all the questions that you haven’t even considered asking but must be asked so that you make informed decisions, have peace of mind, control, power, and influence.

I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse manager for over five years. I’ve been consulting and advocating for families in intensive care all over the world for the last 10 years. Just have a look at our testimonial section.

I also represent you in family meetings with intensive care teams, establishing with you whether you should even go to into a family meeting. Most families just rush into family meetings only realizing afterwards they shouldn’t have gone in the first place. They have no strategy. I can set you up with a strategy and I can make sure that during the meeting, the strategy will be implemented so that once again, you get better care, treatment, and outcomes for your loved one when they’re critically ill in intensive care.

Now, we also offer medical record reviews in real time so that you can get a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure or if you are simply suspecting medical negligence, please contact us as well.

Now all of that you get at intensivecarehotline.com, call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com.

Now if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families. 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 will talk to you in a few days.

Take care for now.

• Email counselling/consulting with Patrik
   
• One on One phone/ Skype counselling/consulting with Patrik