Selective Critically ill patients with tracheostomy are eligible for direct from intensive care unit sent home: Case series

Abstract

To reduce the risk of critically ill patients becoming unstable and needing readmission to the intensive care unit (ICU), patients are typically treated in the ward first following discharge from ICU. However, managing patients with advanced or terminal comorbidities or those requiring palliative care differs from general patients. Patients in this category can be discharged immediately to their homes with tracheostomy care and family education. This case series describes the cases and outcomes of patients with direct from ICU sent home (DISH) protocol. Twelve patients were immediately discharged from the ICU upon completion of treatment. Following the established standard operating procedure, they underwent DISH from the ICU. Early tracheostomy was performed in every patient (from day 1 to day 12th postintubation). All patients were safely discharged following the DISH procedure. According to the findings of this case series, DISH of critically ill patients with tracheostomy cannulas can be executed securely if the patient management method is firmly established. This technique must involve a good education process involving the ICU team, doctors, and family/companions.