After Many Months in ICU After Subarachnoid Hemorrhage, Seizures&Tracheostomy, A Patient Can Go Home

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After Many Months in ICU After Subarachnoid Hemorrhage, Seizures&Tracheostomy, A Patient Can Go 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 department bypass services. We have done so successfully for the Western Sydney Local Area Health District, their in-touch program, saving $2,000 per ED bypass service. Basically, we send critical care nurses into the home for either ICU or ED.

Now today, I want to focus once again on conditions that we can actually look after in the community. Today, I want to just read out the discharge summary from a patient that has been discharged to Intensive Care at Home. So, here’s the discharge summary,

“Critical Care Medicine Discharge Summary

74-year-old female on the 31st of August 2024 with past medical history of aneurysmal subarachnoid hemorrhage, hyperthyroidism, lupus, CABG (Coronary artery bypass grafting), non-Hodgkin’s lymphoma, hypertension, chronic kidney disease who presented to ED with seizure like activity. Patient family given her 4 mg of Lorazepam inadvertently, although 2 mg of Lorazepam was prescribed which resulted in respiratory arrest and patient transferred to the emergency department requiring bag mask ventilation.

Reportedly, patient had been recommended hospice care at the hospital, but it has not been established as family wanted to continue with her management at home with home health such as Intensive Care at Home.

She has extensive neurological history at the hospital where she was initially admitted in March 2024 which included subarachnoid hemorrhage secondary to right MCA (Middle Cerebral Artery) aneurysm and VP (Ventriculoperitoneal) shunt placement. Patient was discharged to inpatient rehab and presented back in July 2024 for sepsis and malfunctioning VP shunt which was reportedly removed. However, it’s visible on the current CT scan.

The patient developed subdural hematoma requiring surgical evacuation. On August the 9th, the patient experienced generalized tonic-clonic seizures and was readmitted back to ICU for a couple of weeks. She was discharged and bounced back to ICU straight away on Depakote and Vimpat, but she was not able to fill the prescription for Brivaracetam.

Presented back to ICU on the 31st of August requiring ventilation support. Antiseizure medication adjusted with continuous EEG (Electroencephalograph). Currently off. Tested positive for C. diff and supplied with adequate treatment.

The seizures and the intracranial insult were followed by pneumonia process which was adequately treated.

Continue reading at: https://intensivecareathome.com/after-many-months-in-icu-after-subarachnoid-hemorrhage-seizures-tracheostomy-a-patient-can-go-home/