Most lifetime value (LTV) patients can still receive continuum care after the intensive care unit. The intensive care unit should not be the last treatment or care in their continuum of care. Over the decades, many patients have transited from intensive care units (ICUs) successfully and are enjoying an enhanced quality of life in other care settings. They have been able to live much better lives with the great alternative care settings out there besides the intensive care unit.
Nevertheless, having a meaningful engagement with the family of the patient and the patient concerning potential next moves is very important. You can transit a patient that is medically stable but dependent on a ventilator to their home, long-term health care facility, or a supportive home from the intensive care unit (ICU).
However, at this point in the treatment of the patient, the medical practitioner involved needs to make sure that the patient, as well as those that will be taking care of the patient, are comfortable with moving out of the intensive care unit. They should also make sure that they have found the right rehab service that will take care of the patient once they leave the intensive care unit.
Transitioning the vent unit of a patient requires a lot of careful consideration. For you to successfully transition a patient from the intensive care unit to a rehab service, their home, or another health care facility, you need to plan the entire process carefully. The process also requires a lot of families and patient education. The family of the patient is also involved as much as the patient.
Things to Consider Before Transitioning a Patient from ICU
There are some vital factors you need to consider before Initializing Mobilization Program. If any of the following conditions occur, a physician should be consulted before the initialization of mobilization:
1. CNS Impairment
- When the patient is unarousable – no physical stimulation or response to voice.
- Deep sedation. This is when a patient makes a move or opens their eyes to physical stimulation but does not respond to voice.
- Removes or pulls catheters or tubes.
- Violent, combative, danger to workers.
2. Poor Oxygenation
- FIO2 is more than 0.6
- SaO2 is less than 88 percent
- PEEP is more than 10cm H2O
3. Tachypnea
- The respiratory rate is greater than 40/min.
4. Acidemia
- The most recent Arterial pH is less than 7.25
Here are a couple of interventions that you can consider:
- Reduce the size of the tracheostomy tube to help with weaning and speech
- Consider switching to a tight-to-the-shaft tracheostomy or cuffless tube to help with weaning and speech.
- Switch the patient to a severe care ventilator.
- Swallowing assessment
- Make sure the patient is in an area with less activity.
- Allow patients to direct their own care.
- Teach and encourage them to use a call bell.
- Dress patients in their own clothing instead of the gowns of the hospital.
- Make sure the patient sits on a chair every day and increase the length of time.
