My Mom's in ICU for Months with Stroke, She's Stuck on the Ventilator&Tracheostomy, We Want Her Home

https://intensivecareathome.com/my-moms-in-icu-for-months-with-stroke-shes-stuck-on-the-ventilator-tracheostomy-we-want-her-home/

My Mom's in ICU for Months with Stroke, She's Stuck on the Ventilator & Tracheostomy, We Want Her 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 adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), 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 services at home.

We’re also sending our critical care nurses into the home for emergency bypass services as we have done so successfully for the Western Sydney Local Area Health District, their in-touch program. We basically cut the cost of an intensive care bed by 50%. By avoiding emergency department admissions, we’re roughly saving $2,000 per ED admission that we are avoiding.

Now today, I actually want to look at a client that we are in the process of assessing for home care. I want to talk more about the medical history so that families, patients, but also, health professionals understand our capabilities for home care. So, this is actually a lady in her 70s who’s got a history of focal motor seizure, acute respiratory failure. She’s got apnea, she’s got a history of subarachnoid hemorrhages, she’s got renal impairment, and she’s got coronary artery disease. So, she’s been stuck in ICU for months on end.

“She still has a high white cell count…”

I’m just reading out the medical report here:

“…but white cell count is improving, and it’s decreased from 19.7 to 17.1. The CRP (C-reactive protein) is still high as well but also decreasing.”

Again, white cell count and CRP are signs of infection markers. This is the issue in ICU that patients are much more prone to an infection than they are in a home care environment because ICUs are “dirty,” which means they are full of infections, full of bacteria, full of virus. As soon as you take a patient out of ICU, they’re much less prone to infections, especially when patients are tied to a ventilator. This lady is in respiratory failure and can’t come off the ventilator.

The report continues:

“The arterial blood gas was done on the 9/16/2024 which was adequate. The recent CT chest showed mild basilar atelectatic changes, but no definite infiltrates were noted. The patient cannot be weaned off the ventilator. She becomes apneic (stops breathing) and takes a few shallow breaths which is more due to central neurological problems. The ICU doctors advised to continue the current management.

The vital signs of the patient are acceptable, within the normal ranges except for high blood pressure readings of 183/101 and 184/93. Temperature is 36.4 °C. Heart rate is 76. Blood pressure and oxygen saturation, 100%. The patient is on medications for her high blood pressure such as hydralazine, 10 mg, 0.5 mls, IV Push, every 4 hours as needed (PRN), Amlodipine 5 mg oral tablet.

Continue reading at: https://intensivecareathome.com/my-moms-in-icu-for-months-with-stroke-shes-stuck-on-the-ventilator-tracheostomy-we-want-her-home/