SMA1 baby intubated, tracheostomy!

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curiousgeorge
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SMA1 baby intubated, tracheostomy!

Postby curiousgeorge » Thu Mar 17, 2016 12:21 pm

My baby has now failed two extubation attempts and they say that they must tracheostomize him. What should I do?

(Asked by a parent)

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bachjr
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Re: SMA1 baby intubated, tracheostomy!

Postby bachjr » Thu Mar 17, 2016 12:22 pm

Give them copies of my articles on how to extubate unweanable babies and tell them that they can call me to answer their questions after they read them. Usually they have a student call, then a resident, then a fellow, then an attending and none of them other than the student reads my articles very carefully so that I have to read the proper procedures several times. Tell them only to have fellows or attendings call me and I will be happy to answer their questions.

If you absolutely refused tracheotomy, they will have to call for advice and your baby will most certainly be transferred to us or another Center of Noninvasive Respiratory Management (look up the nearest one for directions for transfers) to be extubated without a tracheostomy tube but you will have to be firm about refusing tracheotomy for Medicaid or your insurance to pay for the transfer.

We have had babies intubated for over 5 months and fail 5 to 6 extubation attempts and be extubated successfully in under 24 hours upon transfer simply by extubated them according to the principles described in the articles, that is, to CNVS and MIE with the family applying the latter.

JB
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School


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