The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

DISCHARGE AND TRANSFER OF A VENTILATOR DEPENDENT PATIENT FROM OUT-OF-STATE TO HOME: A CASE REPORT

Clint Swanson, Louis M. Kaufman; Roberts Home Medical, Inc., Germantown, MD

Introduction: Transferring ventilator dependent patients from an acute care facility to home requires an orchestrated effort on the part of the family, caregivers, institution, community, and respiratory home care company. This process is near impossible when geographic separation prohibits local home care personnel from conducting the patient evaluation and caregiver education prior to discharge. We report on collaboration by two non-related independent respiratory homecare companies to safely and successfully discharge a ventilator dependent patient to home. Case Summary: A 60 y/o male suffered a complete C-1/C-2 spinal cord injury on 09/06/08. His water accident resulted in near drowning and cardiac arrest. He was resuscitated at the scene and was transferred to a tertiary care facility. Intensive treatment including mechanical ventilation via tracheostomy continued until 02/02/09 when the patient was transferred to an acute rehabilitation hospital in New Jersey. Discharge planners were subsequently unable to locate a respiratory homecare company to accept the patient for transfer to his home in Virginia. The usual process for out-of-state ventilator patient acceptance included transfer to a local in-patient facility for evaluation and training. In this case, the discharging institution refused to transfer to a local facility. AtHome Medical, a partner member of the MED Group’s National Respiratory Network, contacted us on 04/15/09 and we agreed respiratory therapists from AtHome Medical and Roberts Home Medical would work together to facilitate a safe and quality transfer for this patient to his home. AtHome Medical respiratory therapists conducted caregiver training and patient acclimation to the home ventilator prior in New Jersey: Roberts Home Medical respiratory therapists performed the home evaluation, equipment setup, and caregiver training in Virginia, and information was communicated frequently. On 5/7/09 the patient arrived home by air ambulance. Since his return home, he has been hospitalized once for a bowel resection, and has not required hospitalization for any respiratory related condition. Discussion: Long-distance facility to home transfers of ventilator dependent patients can be accomplished through a collaborative effort of accredited respiratory home care companies. Effective communication, patient evaluation and caregiver education are required to effect a safe transition. Sponsored Research - None