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Can my Sister have BiPAP or CPAP Overnight via Tracheostomy?

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Good morning, good afternoon, good evening, wherever you are. Welcome to another livestream today from Intensive Care at Home at intensivecareathome.com. But we also now incorporate questions today from intensivecarehotline.com.

Just to draw a quick distinction. With Intensive Care at Home, we provide Intensive Care at Home services for predominantly long-term ventilated adults and children with tracheostomies, but also home TPN, seizure management at home, as well as tracheostomy care as well as non-invasive ventilated adults and children at home. With intensivecarehotline.com, we provide consulting and advocacy for families in intensive care.

Now, before we go into today’s question, just a couple of things. You may wonder what makes me qualified to talk about today’s topic which is, “Can my sister have BIPAP (bilevel positive airway pressure) or CPAP (continuous positive airway pressure) overnight via tracheostomy?” Again, my name is Patrik Hutzel, founder of Intensive Care at Home and intensivecarehotline.com. I’m a critical care nurse by background. I have worked in intensive care/critical care for over 20 years in three different countries, and I have also worked as a nurse unit manager for over five years in intensive care.

We’ve been providing Intensive Care at Home services for the last 10 years, predominantly on the east coast of Australia, Melbourne, Sydney, Brisbane, but we are now also operating all around the country in Australia. And we bring a wealth of knowledge in this space to the market. We bring a wealth of knowledge and intellectual property to this space for Intensive Care at Home. With intensivecarehotline.com, we’ve been advocating and consulting families in intensive care all around the world for the last 10 years as well.

Now without further ado, let’s get into today’s topic, “Can my sister have BIPAP or CPAP overnight by a tracheostomy?” Please type your questions into the chat pad after we’ve gone through today’s questions. I will also open up the phone line so you can dial in live on the show with the questions, but let’s go through today’s questions first.

So, I had an email from a client this week where I thought, “Oh, this is a really good question because we get similar questions quite frequently.” So, I thought this is a really good topic to record in a video and put it on our blog so more people can learn and understand about what’s really happening in home care, but also in intensive care. Where’s the interface and how can patients be safely managed at home whilst having quality of life at home and also no longer block a bed in intensive care?

So, let me read out this email from the reader this week. “My sister was unable to tolerate to return to two liters nasal cannula and left on the tracheostomy collar, 35% humidified oxygen due to thick secretions and she was transferred to physical rehab from ICU.” So, for anyone that doesn’t know what a tracheostomy collar is that this lady is describing her sister that has been on a ventilator with a tracheostomy. She’s now weaned off the ventilator. She’s now having the tracheostomy and she’s still needing humidified 35% oxygen on the tracheostomy. Because when you’re bypassing breathing in through the nose, which is basically what you’re doing when you’re breathing with a tracheostomy, air doesn’t get humidified. When you’re breathing in through the nose, your air automatically and naturally gets humidified. So, because you’re bypassing the nose when having a tracheostomy, air needs to be humidified so that secretions are not drying up, so that the lungs don’t get blocked, but also so that the tracheostomy doesn’t get blocked with thick, dry secretions.

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