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I'm a Case Manager in ICU & My Client Has a Permanent Tracheostomy, Can She Go Back to a Group Home?
I'm a Case Manager in ICU & My Client Has a Permanent Tracheostomy, Can She Go Back to a Group Home?
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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home, otherwise medically complex clients at home, which includes BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) ventilation, home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions, as well as home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management as well as Hickman’s line management, and we also provide palliative care at home.
We also have sent and we continue to send our critical care nurses into the home for emergency department bypass services, and we have done so successfully in the past for the Western Sydney Local Area Health District, their in-touch program.
So, today I actually have an email from a case manager in a hospital who says,
“Hi Patrik,
I’m a case manager and I have a patient on my caseload that was sent to the emergency room a few months ago for assessment of lethargy. In the emergency department, she was found to be having nonstop silent seizures. Her airway became obstructed, and they intubated her.
She was also diagnosed with sepsis due to a UTI (UTI stands for urinary tract infection). She then was found to have sustained several moderate strokes. They have stabilized her and she’s no longer having seizures. However, when they tried to extubate her last week, within an hour, they had to reintubate her again because her trachea had narrowed, and they had to insert a pediatric tube.
She no longer requires the ventilator, but she now has a tracheostomy and will need the tracheostomy most likely for the rest of her life. We questioned if she just had sustained swelling to the trachea, which could be resolved on its own. But the doctor said a narrowed trachea is considered to be permanent. So, now she has the tracheostomy permanently.
The patient has an intellectual disability and normally lives in a group home. The group home is not sure if they can take her back safely with a tracheostomy. I’m not even sure what to even ask the advocate for. We certainly don’t want to see her winding up in hospital or in ICU for months on end. Let alone let her go to a nursing home which I don’t believe can take tracheostomy patients anyway.
Can you help?”
This is from Rose, a case manager from a hospital.
Now, Rose, thank you so much for writing in. Again, this sounds like bread and butter for us. We’ve done it over and over and over again. We’ve been in business since 2012 with Intensive Care at Home. Like I said in the intro, we are highly specialized in ventilation, tracheostomy care at home with 24-hour critical care nurses, which is what a patient needs when they have a tracheostomy and/or ventilation requirements.
Now, in terms of your client going back to a group home, that is possible with Intensive Care at Home because at the end of the day, we go wherever the clients or patients need care and we are providing services to patients in group homes.
Continue reading at: https://intensivecareathome.com/im-a-case-manager-in-icu-my-client-has-a-permanent-tracheostomy-can-she-go-back-to-a-group-home/
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