Oral intubation kiddos in a home setting?

Specialties Private Duty

Published

Specializes in PDN; Burn; Phone triage.

Decided to pick up a few shifts with the PDN agency that I worked with before the hospital job. They offered me a shift with a "busy" infant who is...orally intubated.

I'm beginning to wonder if the shift coordinator - who is not medically trained - became confused. The kiddo isn't home yet, but she kept insisting that he was coming home intubated but didn't have a trach.

Has anyone ever heard of this before? I'm just thinking that this can't be reasonable/possible. But my only experience is with adult burn patients who have gone from prolonged oral intubation to being trached and weaned off the vent. So my train of thought could be totally off base.

Any thoughts?

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Specializes in Trauma Surgical ICU.

I have no experience in home health but in the ICU many of our pts are trached after 2 weeks if they are not able to wean, some go home some go to LTCF that take trachs. I have never seen or heard of someone going home intubated.. On the vent with a trach yes but not oral intubation..

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Specializes in Home Health/PD.

In PD I have never seen this. Doesn't seem safe for the child or the caregiver. That tube could easily be displaced if the pt truly is a busy infant!

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Never seen that in private duty. I never trust a manager that isn't a nurse. They should leave that stuff to nurses.

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Specializes in PICU, Sedation/Radiology, PACU.

No way. You simply cannot safely have an infant who is orally intubated and non-sedated out of an acute care setting. That baby would fight the tube and have it out in a second. Then what? You've got no one in the immediate area who is qualified to reintubate. Bag the patient and call 911? Every day?

No, OP, this won't happen. Your supervisor likely misunderstood.

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Specializes in Pediatrics.

I've worked with a patient on a NIV 24/7, who I think probably should've had a trach, but the mask was the same (or very similar) to a CPAP mask. There was no artificial airway and I don't see how an infant would be d/c to home with an ET. ??

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Specializes in OB/GYN/Neonatal/Office/Geriatric.

Maybe the "intubation" is actually a feeding tube or suction or something entirely different. Is there a medical record to be looked at? I can't believe an infant would be sent home with an ETT. How old is this baby?

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Specializes in peds palliative care and hospice.

maybe they mean bipap via mask or something? I have never heard of that either, unless it is a hospice situation and the child will be extubated at home with comfort care measures in place.

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I have never heard of this...and I would be concerned about working for an agency where your clinical director isn't a nurse or medical professional!

I would imagine an infant wouldn't be discharged unless trach'd....

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Maybe they mean the baby has an NG tube and he/she has taken their extremely limited medical knowledge and tried to sound smart by using "orally intubated" to describe the baby?

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Did you ever find out what was actually going on? Just curious.

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