INTENSIVE CARE HOTLINE http://intensivecarehotline.com is instantly improving the lives of Families of critically ill Patients in Intensive Care, so that they have PEACE OF MIND, power, influence decision making and stay in control of their Family's and their critically ill loved one's destiny Mon, 21 Apr 2014 09:00:12 +0000 en-US hourly 1 The INTENSIVECAREHOTLINE.COM Podcast features topics that support Families of critically ill Patients in Intensive Care. INTENSIVECAREHOTLINE.COM is instantly improving the lives of Families of critically ill Patients in Intensive Care, so that they can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! Patrik Hutzel yes Patrik Hutzel patrikhutzel@optusnet.com.au patrikhutzel@optusnet.com.au (Patrik Hutzel) INTENSIVE CARE HOTLINE- ALL RIGHTS RESERVED INTENSIVECAREHOTLINE.COM Podcast Health, Intensive Care, Critical Care, Family support, Family education, critically ill, intensive care hotline INTENSIVE CARE HOTLINE http://intensivecarehotline.com/wp-content/plugins/powerpress/rss_default.jpg http://intensivecarehotline.com TV-G How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS http://intensivecarehotline.com/stop-intimidated-intensive-care-team-will-seen-equals/ http://intensivecarehotline.com/stop-intimidated-intensive-care-team-will-seen-equals/#comments Mon, 21 Apr 2014 09:00:12 +0000 http://intensivecarehotline.com/?p=6634 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+STOP+being+INTIMIDATED+by+the+Intensive+Care+team+and+how+you+will+be+SEEN+as+EQUALS.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In […]

How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS is a post from: INTENSIVE CARE HOTLINE

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

In last week’s blog I’ve shown you The 4 ways you can overcome insurmountable obstacles whilst your loved one is critically ill in Intensive Care!You can read, watch or listen to the update here.

In this week’s blog I want to show youHow to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS”

One of the biggest challenges whilst you have a family member or a close friend in Intensive Care is the perceived power imbalance between you, your Family and the Intensive Care team.

After all, Intensive Care is a scary environment and it’s an environment that you most likely got to know without any preparation and/or prior knowledge.

And after the initial shock has worn off and after the awareness has kicked in that you now have to deal with this scary, frightening, intimidating and challenging environment, you have probably also realized that you, your Family and your critically ill loved one are now in a position where you are dependent on other people.

The Intensive Care team is “calling the shots” so to speak and they are used to make decisions in an environment where you and your Family feel challenged, overwhelmed, vulnerable, stressed and out of your comfort zone.

“The Elephant in the room” or how the Intensive Care team is making decisions

You and your Family are often so overwhelmed by the events that are happening all around you and you have no idea and no insights about how the Intensive Care team is making decisions and is coming to conclusions.

You and your Family consciously or unconsciously also feel intimidated by the Intensive Care team and your perceptions about the Intensive Care team’s perceived power and authority will most likely have taken over. After all this is how most societies think and operate, that a doctor or a nurse knows “what’s best” in an environment like Intensive Care. After all you and your Family are dealing with smart, educated and professional people, right?

Those smart, educated and professional people within the Intensive Care team are also letting you know whether through their tone of voice, through their body language and just simply through their actions that they have all the control, power and influence in this situation.

Again, this is how they’ve been trained and conditioned to behave. Their decision making power and authority is rarely been questioned by Families of critically ill Patients in Intensive Care and that’s a big challenge that you and your Family need to overcome!

 PEACE OF MIND, control, power and influence are critical for you and your Family

The reality is that if you, your Family and your critically ill loved one are finding yourself in one of the most challenging situations in your life such as having a loved one critically ill in Intensive Care you want to and you need to have as much PEACE OF MIND, power, control and influence as possible.

The reality and the fact of the matter is that if your loved one is critically ill in Intensive Care and is facing a situation where they are

  •  very unstable and in a very critical condition
  •  in a life threatening situation
  • in Intensive Care for long-term treatments and long-term stays
  • approaching their end of life in Intensive Care

 The wheels that are in motion “behind the scenes” and the wheels that are in motion where and how the Intensive Care team is positioning your critically ill loved one’s diagnosis and prognosis in a certain light that suits the Intensive Care team’s agenda, remains mainly hidden from you and from your Family.

Don’t be oblivious and “blind” to the things that are happening “behind the scenes” in Intensive Care

The thing is that in more than 15 years Intensive Care nursing in three different countries, I have seen and learned things that you and your Family have no idea about. You and your Family are mainly oblivious to the fact that the Intensive Care team has worked out their positioning way before you have even set a foot into the ICU and especially in challenging end of life situations, in situations where your loved one is very critical and/or unstable and/or if your loved one is in Intensive Care for a long-term stay, you certainly don’t want to be like 99% of Families of critically ill Patients who have no idea about what’s really happening in Intensive Care “behind the scenes”.

Those Families of critically ill Patients have no PEACE OF MIND, no control, no power and no influence and the life and the well being of their critically ill loved one is in the hands of the Intensive Care team only.

Remember, you, your Family and your critically ill loved one are in a “once in a lifetime” situation where the level of control, power and influence you and your Family have, will directly impact on the outcome of your critically ill loved one’s stay in Intensive Care.

The reality and the fact of the matter is that you want to belong into that tiny little 1% bracket of Families of critically ill patients in Intensive Care who have PEACE OF MIND, control, power and influence.

You see, the Intensive Care team will not shed any light on how they are coming to conclusions and how they are making decisions and they certainly won’t tell you and your Family what’s happening “behind the scenes”.

Most decisions made by the Intensive Care team, especially when your loved one is in one of those challenging situations such as

  • a critical and unstable situation
  • a long-term stay in Intensive Care
  • a life threatening situation
  • a perceived end of life situation

If you and your Family are like 99% of Families of critically ill Patients in Intensive Care you won’t question the authority of the Intensive Care team, you won’t take look “behind the scenes” and you just take everything for “FACE VALUE”. As you know by now, the very life and the very recovery and the very well being of your critically ill loved one very much depends on the level of insights, power, control and influence you have and that will lead you directly to PEACE OF MIND.

Start asking the right questions instead and take a look “behind the scenes”

So in order for you to stop being intimidated by the Intensive Care team and in order for you and for your Family to be seen as equals you need to know that most decisions in Intensive Care, made by the Intensive Care team are often based on

  • the perceived financial viability of your loved one’s stay in Intensive Care. Or in other terms, does the Intensive Care team think they will make money or will they lose money if they continue treating your critically ill loved one
  • the bed status in the Intensive Care Unit and how many other admissions are waiting for a scarce, precious and expensive Intensive Care bed that implicitly or explicitly weighs up your loved one’s stay against other potential admissions
  • how the Intensive Care team views you and your Family. Do you and your Family have an understanding about what’s really going on? Are you and your Family asking the right questions or do you take everything for FACE VALUE? Are you and your Family intimidated by the Intensive Care team, because the unfortunate reality is that most Families of critically ill Patients in Intensive Care are intimidated by the Intensive Care team

Related Article:

How you and your Family are perceived is directly linked to the care your critically ill loved one is receiving or not receiving in Intensive Care

 

  • RESEARCH activities in the Intensive Care Unit. RESEARCH is a multi-million dollar $$$ industry and even more so in Intensive Care.5,6 or 7 figure funding $$$ is going into RESEARCH every year in Intensive Care Units so that Doctors and Nurses can publish papers about their RESEARCH activities in Intensive Care. Guess who they do the RESEARCH on? They do it on critically ill Patients in Intensive Care and the unfortunate and grim reality is that resources are often allocated, depending on RESEARCH activities. The fact of the matter is that one way or another your critically ill loved one’s case and treatment is being weighed against criteria that goes way beyond your critically ill loved one’s prognosis and diagnosis. For example, if the Intensive Care team thinks that your critically ill loved one doesn’t fall into a RESEARCH category then they may suggest a “withdrawal” or a “limitation of treatment” is “in the best interest of your critically ill loved one and therefore the Intensive Care team wants to focus on treating other Patients where they continue their RESEARCH activities, publish their papers and therefore attract more 5,6 or even 7 figure Dollar $$$ funding for more RESEARCH activities. The same applies if your critically ill loved one is actually dying and therefore their suffering is prolonged. The Intensive Care team may suggest to you and your Family to continue treatment because your critically ill loved one is falling into a RESEARCH category and therefore a continuation of treatment is in the “best interest” of the Intensive Care team and it may unnecessarily prolong the suffering of your critically ill loved one, whilst the Intensive Care may give you false hope with the same end result of your loved one dying.

 

It’s “BEHIND THE SCENES” where all the decisions are being made

So as you can see, decision making in Intensive Care, when it comes to difficult situations is never linear and/or straight forward. It depends heavily on what’s happening “behind the scenes” and it’s dependent on the Intensive Care team’s positioning, the politics, the intrigue, the psychology, the power play and the dynamics. Most of all if you don’t know and if you don’t quickly learn any of that stuff you will continue being intimidated by the Intensive Care team, because they have the upper hand and they keep you at arm’s length if you let them…

How can you get to that all important feeling of PEACE OF MIND, power, control and influence whilst your loved one is critically ill in Intensive Care?

You get to that all important feeling of PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!

In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE reports you’ll also discover
• how to ask the doctors and the nurses the right questions

  • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
  • How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
  • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
  • You’ll get real world examples that you can easily adapt to your situation
  • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
  • You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
  • How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Sincerely, your Friend
Patrik Hutzel

Related Articles:

How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS is a post from: INTENSIVE CARE HOTLINE

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http://intensivecarehotline.com/stop-intimidated-intensive-care-team-will-seen-equals/feed/ 0 http://youtu.be/ZK47RZk5-EM https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+STOP+being+INTIMIDATED+by+the+Intensive+Care+team+and+how+you+will+be+SEEN+as+EQUALS.mp3 - Hi, http://youtu.be/ZK47RZk5-EM https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+STOP+being+INTIMIDATED+by+the+Intensive+Care+team+and+how+you+will+be+SEEN+as+EQUALS.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve shown you “The (http://intensivecarehotline.com/the-4-ways-you-can-overcome-insurmountable-obstacles-whilst-your-loved-one-is-critically-ill-in-intensive-care/) 4 ways you can overcome insurmountable obstacles whilst your loved one is critically ill in Intensive Care! (http://intensivecarehotline.com/the-4-ways-you-can-overcome-insurmountable-obstacles-whilst-your-loved-one-is-critically-ill-in-intensive-care/)” You can read, watch or listen to the update here. In this week’s blog I want to show you “How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS” One of the biggest challenges whilst you have a family member or a close friend in Intensive Care is the perceived power imbalance between you, your Family and the Intensive Care team. After all, Intensive Care is a scary environment and it’s an environment that you most likely got to know without any preparation and/or prior knowledge. And after the initial shock has worn off and after the awareness has kicked in that you now have to deal with this scary, frightening, intimidating and challenging environment, you have probably also realized that you, your Family and your critically ill loved one are now in a position where you are dependent on other people. The Intensive Care team is “calling the shots” so to speak and they are used to make decisions in an environment where you and your Family feel challenged, overwhelmed, vulnerable, stressed and out of your comfort zone. “The Elephant in the room” or how the Intensive Care team is making decisions You and your Family are often so overwhelmed by the events that are happening all around you and you have no idea and no insights about how the Intensive Care team is making decisions and is coming to conclusions. You and your Family consciously or unconsciously also feel intimidated by the Intensive Care team and your perceptions about the Intensive Care team’s perceived power and authority will most likely have taken over. After all this is how most societies think and operate, that a doctor or a nurse knows “what’s best” in an environment like Intensive Care. After all you and your Family are dealing with smart, educated and professional people, right? Those smart, educated and professional people within the Intensive Care team are also letting you know whether through their tone of voice, through their body language and just simply through their actions that they have all the control, power and influence in this situation. Again, this is how they’ve been trained and conditioned to behave. Their decision making power and authority is rarely been questioned by Families of critically ill Patients in Intensive Care and that’s a big challenge that you and your Family need to overcome!  PEACE OF MIND, control, power and influence are critical for you and your Family The reality is that if you, your Family and your critically ill loved one are finding yourself in one of the most challenging situations in your life such as having a loved one critically ill in Intensive Care you want to and you need to have as much PEACE OF MIND, power, control and influence as possible. The reality and the fact of the matter is that if your loved one is critically ill in Intensive Care and is facing a situation where they are *  very unstable and in a very critical condition intensiv yes
How LONG can someone stay in an INDUCED COMA? http://intensivecarehotline.com/long-can-someone-stay-induced-coma/ http://intensivecarehotline.com/long-can-someone-stay-induced-coma/#comments Sun, 20 Apr 2014 09:00:39 +0000 http://intensivecarehotline.com/?p=6628 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+LONG+can+someone+stay+in+an+INDUCED+COMA-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

How LONG can someone stay in an INDUCED COMA? is a post from: INTENSIVE CARE HOTLINE

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of your questions answeredand in last week’s episode I answered another question from one of our readers and the question that I answered was “A family member of ours in his thirties is dying in Intensive Care and we’re not sure whether it’s the only option, please help!” You can check it out here.

In this week’s episode of your questions answered, I answer another question that many of our readers want to know about, if their loved one is critically ill in Intensive Care and in this week I want to answer “How long can someone stay in an induced coma?”

Critical illness in Intensive Care often requires mechanical ventilation, a breathing tube(endotracheal tube) and an induced coma.

All of those interventions, mechanical ventilation, the breathing tube(endotracheal tube) and the induced coma are interventions that are very scary for your critically ill loved one as well as for you and for your Family.

When you first see your critically ill loved one in this situation where they require a ventilator, a breathing tube and they are in an induced coma you may feel shocked or unpleasantly surprised when you first see how unfamiliar your critically ill loved one looks.

It’s even worse if your critically ill loved one requires a ventilator, the breathing tube and the induced coma if they had an accident and they may have bandages and dressings around their arms, legs or head. They may also have blood in their face and on other body parts. It’s not a pleasant look and feel for you and your Family.

Why is the induced coma required?

But first of all, let’s quickly look at why your critically ill loved one needs to be in an induced coma.

Whenever a critically ill Patient gets admitted to Intensive Care and requires mechanical ventilation on a ventilator or respirator, a breathing tube(endotracheal tube) and the induced coma is also required in order to establish a secure airway. Your critically ill loved one needed the ventilator/ respirator and the breathing tube because they either couldn’t maintain a safe airway or they stopped breathing altogether because of the critical situation they have been in.

Another scenario or situation that can lead to mechanical ventilation, the breathing tube(endotracheal tube) and the induced coma is that your critically ill loved one required surgery, they were therefore induced into a coma in the operating theatre and depending on the length of the procedure, complications such as bleeding and/or haemodynamic and/or respiratory(breathing) issues they now require Intensive Care for mechanical ventilation, the breathing tube(endotracheal tube) and the induced coma as a safety and/or prophylactic measure.

As a rule of thumb, whenever a critically ill Patient requires mechanical ventilation and a breathing tube(endotracheal tube) they automatically will need to be in an induced coma. The reason for the induced coma is that your critically ill loved one wouldn’t be able to tolerate a breathing tube in their throat whilst being attached to a ventilator/ respirator. The breathing tube as well as the positive pressure and the volume that gets delivered into the lungs would be very uncomfortable to be tolerated without a medically induced coma.

On the other hand a medically induced coma would be contraindicated without a ventilator and a breathing tube, because critical, vital and important life saving functions would be compromised and put Patients into a life threatening situation.

The other reason and also advantage for your critically ill loved one when being induced into a coma whilst being critically ill is that critical and vital body functions can be monitored and managed. Many of those vital body functions such as heart rate, heart rhythm, blood pressure, body temperature, brain function and sometimes brain pressures, kidney function, liver function and other body functions as well can recover during an induced coma whilst your critically ill loved one is “put to sleep” so to speak.

The following admission scenarios to Intensive Care most often lead to a medically induced coma and ventilation

 

 What is required for the induced coma?

In order for your critically ill loved one to be induced into a coma, sedative and opiate drugs are required such as

  • Propofol(Diprovan), which is a short acting sedative drug and is commonly used for an induced coma <72 hours
  • Midazolam(Hypnovel/ Dormicum), which is a Benzodiazepine and is more commonly used for long term sedation> 72 hours
  • Morphine, a strong pain killer and opiate
  • Fentanyl, a strong pain killer and opiate

Those drugs are all given intravenously and they should be administered via a central venous line(CVC)

Given that Midazolam is a Benzodiazepine it should be used sparingly, as it can have a tendency to accumulate in the body system and “waking up” after the induced coma maybe prolonged and delayed because the Midazolam is still in the body system even after it has been ceased and it can also make people addicted.

The same applies to Morphine and Fentanyl, the longer those drugs are being used the bigger the risk that they accumulate in the body system as well, “waking up” can get delayed and it can also make people get addicted to those drugs.

Therefore the longer your critically ill loved one stays in an induced coma the higher the risk to go through a withdrawal when waking up out of the induced coma. This is also sometimes the reason why your critically ill loved one may be confused, agitated and non- cooperative at times.

Propofol is a good choice for sedation as it’s short acting and it does have a tendency to let critically ill Patients “wake up” quickly after Propofol has been ceased.

How long can my critically ill loved one stay in an induced coma?

The answer is that it depends. In theory an induced coma can go on for long periods of time, sometimes many weeks, as Michael Schuhmacher the famous formula one racing car driver and former world championship has shown. He was in an induced coma for nearly two months, before he was “woken up”, not without any difficulties.

In most cases, especially when critically ill Patients have been in a coma for more than 3-7 days, “waking up” can be difficult and not linear. It’s often like switching on a light with a “dimmer” and it can be a slow and gradual process.

As I have hinted towards, your critically ill loved one may get confused, agitated and sometimes non- compliant as well. The reason for being confused, agitated and/or being non-compliant is often the side effects from the drugs given during the induced coma.

Related Article:

After weaning off a ventilator is it NORMAL to be confused?

 As a rule of thumb, the length of time where your critically ill loved one stays in an induced coma should be minimized as much as possible. However, depending on the circumstances, sometimes a prolonged induced coma is necessary and may well be in the best interest of your critically ill loved one especially if they are clinically unstable. Especially if they have low blood pressure, head or brain injuries with increased brain pressures, other traumatic injuries and fractures, lung failure and/or bleeding then the induced coma gives your critically ill loved one the time to recover from their illness.

How can you  further leverage your level of PEACE OF MIND, power and influence whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

You’ll get to that all important feeling of PEACE OF MIND, power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE reports you’ll also discover

  • how to ask the doctors and the nurses the right questions
  • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
  • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
  • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
  • You’ll get real world examples that you can easily adapt to your situations
  • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
  • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
  • How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s your questions answered and I’ll see you again in another update next week!

Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Sincerely, your Friend
Patrik Hutzel

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How LONG can someone stay in an INDUCED COMA? is a post from: INTENSIVE CARE HOTLINE

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http://intensivecarehotline.com/long-can-someone-stay-induced-coma/feed/ 0 http://youtu.be/giuUc10MAOc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+LONG+can+someone+stay+in+an+INDUCED+COMA-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/giuUc10MAOc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+LONG+can+someone+stay+in+an+INDUCED+COMA-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , w... intensiv yes
The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care! http://intensivecarehotline.com/the-4-ways-you-can-overcome-insurmountable-obstacles-whilst-your-loved-one-is-critically-ill-in-intensive-care/ http://intensivecarehotline.com/the-4-ways-you-can-overcome-insurmountable-obstacles-whilst-your-loved-one-is-critically-ill-in-intensive-care/#comments Mon, 14 Apr 2014 09:00:40 +0000 http://intensivecarehotline.com/?p=6603 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Overcoming+insurmountable+obstacles.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In […]

The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

In last week’s blog I’ve shown you How to get peace of mind, more control, more power and influence if your critically ill loved one is dying in Intensive Care!” You can read, watch or listen to the update here.

In this week’s blog I want to show you “The 4 ways you can overcome insurmountable obstacles whilst your loved one is critically ill in Intensive Care”

Having a loved one critically ill in Intensive Care can be a daunting, frustrating, challenging and scary experience. Families of critically ill Patients are thrown out of their comfort zone in an instant and they generally feel very vulnerable and they feel like they have no PEACE OF MIND, no control, no power and no influence.

The issues and challenges Families of critically ill Patients are dealing with appear to be insurmountable at the beginning. Especially since the Intensive Care team is holding all the perceived power and 99% of Families of critically ill Patients in Intensive Care don’t challenge that assumption and they don’t question the agenda and the perceived power of the Intensive Care team. They let that perception dominate their reality…

Not a good starting point.

The role the Intensive Care team plays and your perceptions about it…

I know that having a loved one critically ill in Intensive Care appears to be an insurmountable challenge and an insurmountable obstacle for you and your Family, but that’s only because you have handed over all of your power, control and influence to the Intensive Care team the minute you’ve met them and the minute your critically ill loved one was admitted to Intensive Care. You have consciously or unconsciously already decided in your head that the Intensive Care team must have all the answers…

And you’ll be bitterly disappointed when you find out that the Intensive Care team can’t help your critically ill loved one or if they can’t help your critically ill loved one as quickly as you would have anticipated.

Especially since you and your Family are most likely not familiar with the Intensive Care environment you feel like you, your Family and your critically ill loved one face insurmountable obstacles

What if the odds are stacked against you and against your critically ill loved one?

Now, once again if you are in the situation where your loved one has just been admitted to Intensive Care for critical illness and if you and your Family think you have been told that your critically ill loved one is either

  • very unstable and in a very critical condition
  •  in a life threatening situation
  • in Intensive Care for long-term treatments and long-term stays
  • approaching their end of life in Intensive Care

Those situations are extremely challenging, frustrating and in those situations you feel like you are facing insurmountable obstacles and insurmountable challenges and you most likely feel like the odds are stacked against you, against your Family and against your critically ill loved one!

In more than 15 years Intensive Care nursing in three different countries I have seen and dealt with many of those insurmountable challenges and insurmountable obstacles.

The biggest lessons that I have learned in those situations is that it’s usually never as bad as you think it is and that there are ways of how to handle those crisis situations.

Therefore, let’s look at “The 4 ways you can overcome insurmountable obstacles whilst your loved one is critically ill in Intensive Care!”

 1.       Make meaning out of the situation

I know, you probably don’t feel like “making meaning” out of this situation. You probably think, “why me? ”or “why is this happening to my family?” or you may think along the lines of “why must my loved one be going through this?”.

Those feeling and thoughts are normal and they are sort of “intuitive”. Those thoughts are also putting you in a passive position and you have taken and you have assumed the role of a victim. By thinking those thoughts and by having those feelings you have automatically given your level of power, your level of control and your level of influence away and you have directly or indirectly handed over your level of control, power and influence over to the Intensive Care team…

Not good and you are now in a situation where you and your Family have those negative thoughts and negative feelings dominate your feelings, behaviour and your thinking!

The trick here is to change your thinking from  being a “victim” to make meaning out of this situation.

What does this situation mean to you personally, what does it mean for your family and what does it mean for your critically ill loved one?

What’s the meaning behind of this “tragedy”?

Is it that your Family is coming closer together during this time of crisis?

Is it that life is teaching you a lesson about adversity and how to effectively deal with it? Have you and your Family been in other situations where you felt like a victim and you didn’t know what to do about it and you didn’t know how you needed to deal with adversity? The meaning in this situation may well be that dealing with adversity is easier than you think it is, irrespective of the challenges, obstacles and the odds that you are facing…

Is this situation a situation where all of a sudden you can see why your critically ill loved one is in the situation that they are in? If that’s the case you probably feel uncomfortable talking about it and you might not feel like sharing it with the outside world. That’s OK, but know the meaning behind the situation that you’re in and use it to your, your families and your critically ill loved one’s advantage!

2.       Know that you are and that you can be resilient

Did you know that you are a miracle? Did you know that you and your critically ill loved one’s genes have survived over millions of years against many odds?

If you are reading this right now it means that you and your Family are survivors of millions of generations that have come before you! If you think about it, your ancestors not all that long ago didn’t have the luxuries, the modern technology, the medical facilities and modern communication channels available like we have today.

It also means that irrespective of the challenges and obstacles that you are facing now that you, your Family and your critically ill loved have done pretty well over millions of years, because your ancestors knew what to do in situations of crisis, because otherwise you and your Family wouldn’t be here today. It’s as simple as that. You and your Family are resilient, because your ancestors have survived millions or hundreds of thousands of years of adversity, wars, famine and the like, way before modern civilisation like we know it today have been a reality.

That also means that deep down you already know what to do and you know how to deal with adversity and don’t let anybody else tell you any differently…

Think about those stories from your parents, grandparents or even great-grandparents on how they survived adversity during times of crisis and use those strategies to your advantage!

3.       Change your body language

I bet the minute you have heard that your loved one has been admitted to Intensive Care or the minute you have entered Intensive Care, you consciously or unconsciously changed your body language!

I bet you started crossing your arms, you slumped your shoulders, your back is not straight, your chest is bent inwards, you’re avoiding eye contact, you are putting your head down and so on.

How does this type of body language make you feel and what does it say about you? What do you express with that type of body language to the outside world?

Now changing your body language during times of crisis is normal. The challenge is to recognize it and to change it!

Our body language is extremely powerful, positive and negative.

Do you think the Intensive Care team views you as powerful, in control and influential if you are crossing your arms, if your head is down, if you are not standing or sitting straight and if you’re avoiding eye contact?

Do you think your Family and your critically ill loved one think that you are powerful, in control and influential if you are crossing your arms, if your head is down, if you are not standing or sitting straight and if you’re avoiding eye contact?

On the other hand how does it make you feel if you have your body language under control? How do you feel if you

  • Uncross your arms
  • If you make strong eye contact
  • Put out your chest
  • Straighten your back
  • Are holding your head high

I bet the minute you have strong and powerful body language that’s the minute when things will change for you.

You are sending a very strong signal to the world, by telling everybody through your body language that you can overcome insurmountable obstacles and insurmountable challenges.

I bet that your Family, your critically ill loved one and the Intensive Care team will notice. I also bet that you feel more confident if you have your body language handled.

I also bet that the dynamics will shift in your favour immediately…

 4.       Ask the right questions

 Now, if I had a Dollar for every Family that I met in more than 15 years of Intensive Care nursing in three different countries who had no idea what questions they needed to ask in order to not only understand the situation, but also to understand the dynamics in Intensive Care that implicitly or explicitly impact on the care, treatment and also on the positioning of the prognosis and diagnosis of your critically ill loved one by the Intensive Care, I would be a millionaire…

Without you and your Family asking the right questions you certainly will remain powerless, without control and without influence…

By you asking the right questions you will immediately set yourself apart from 99% of Families of critically ill Patients in Intensive Care who have no control, no power and no influence! By you asking the right questions you will instantly make a positive impact in the dynamics with the Intensive Care team, you will set yourself apart and you will immediately belong to that 1% bracket of Families of critically ill Patients in Intensive Care who have PEACE OF MIND , control, power and influence!

The reality is that if you and your Family don’t ask the right questions, the Intensive Care team will have an easy time to drive their agenda and they will have an easy time to keep you at “arm’s length” so to speak…

And being in a situation where your loved one is critically ill in Intensive Care and is in one of those difficult situations where they are

  • very unstable and in a very critical condition
  •  in a life threatening situation
  • in Intensive Care for long-term treatments and long-term stays
  • approaching their end of life in Intensive Care

you simply must ask the right questions and you can’t afford not to look “behind the scenes” and you can’t afford to let the Intensive Care team drive their agenda…

How do you do that, how can you have maximum control, power and influence and how can you get that crucial “behind the scenes” insight whilst your loved one is critically ill in Intensive Care?

You’ll get to that all important feeling of having PEACE OF MIND, power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE reports you’ll also discover
• how to ask the doctors and the nurses the right questions

  • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
  • How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
  • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
  • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
  • You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
  • How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Sincerely, your Friend
Patrik Hutzel

Related Articles:

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A family member of ours in his 30′s is DYING in Intensive Care and we’re not SURE whether it’s the ONLY OPTION, please help! http://intensivecarehotline.com/a-family-member-of-ours-in-his-30s-is-dying-in-intensive-care-and-were-not-sure-whether-its-the-only-option-please-help/ http://intensivecarehotline.com/a-family-member-of-ours-in-his-30s-is-dying-in-intensive-care-and-were-not-sure-whether-its-the-only-option-please-help/#comments Sun, 13 Apr 2014 09:00:28 +0000 http://intensivecarehotline.com/?p=6598 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/A+family+member+of+ours+in+his+30%27s+is+DYING+in+ICU+and+we%27re+not+SURE+whether+it%27s+the+only+OPTION.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! […]

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of your questions answered and in last week’s episode I answered another question that our readers ask quite frequently and the question was “How long does it take to wake up after an induced coma?You can check it out here.

In this week’s episode of your questions answered, I answer another question from one of our readers and in this Kathrine from Sydney, Australia is asking “A family member of ours in his thirties is dying in Intensive Care and we’re not sure whether it’s the only option, please help!”

Kathrine writes

Hi Patrik,

Thank you for your website, it is really helpful!

I am just wondering if you could assist me with my question please. One member of my family (on my husband’s side) is being put to sleep…for good…, after a shocking operation on his chest. He had a tube in his mouth and that was helping him with his breathing and the machine was just assisting him…

However, just two days ago, me and my husband visited him. Our Family friend was active and alive, he wanted to talk to us, but he was given more drugs to calm him down… And now, two days later, we found out that he will die…So we are extremely shocked to find out that apparently nothing can be done to save him…Why did the doctors not insert a Tracheostomy tube…? Please see the photos attached. Our Family member is only young and in his thirties. We know that he was trying to breath by himself and that only 1/4 of his lungs are functional…Does that mean that there was no other options?…But to put him to sleep and let him die?…His father has got all the decision making authority, but I am unsure whether his father understands the whole situation.

So what was happening, all sudden our dear nephew felt pain in his chest…So he was rushed to hospital and then they discovered a huge tumour in his chest…He had 2 operations, but the surgeons could not remove it all and put him on a drip for a cancer treatment…Sorry I don’t know the right terminology, but this is what was happening…And I was sure he can survive.It is very confusing, as we don’t know what went wrong! Sorry, it’s very hard time for us right now…Thank you for your website anyway, it did made me feel understood and heard…

Thank you,

Kathrine

Dear Kathrine,

thank you for your question.

I am shocked and appalled by how you are describing how your Family member has been dealt with.

In the pictures that you’ve sent he looks far too young and healthy to be left to die and just because he “only” has 25% of his lungs functional is no reason to “put him to sleep” and let him die, without looking whether the right decisions have been made and also without your Family member being involved in the decision making process.

On the pictures your Family member looks like he would be quite capable in getting involved in the decision making process about his own end of life at such a young age. The unfortunate reality however is that the Intensive Care team doesn’t really want to talk about the issues of death to the Patient. Even for the Intensive Care team it feels hard, difficult and awkward to speak to a Patient about their death, so the easy way out is to “just put him to sleep”.

Even though the Intensive Care team is dealing with death and end of life situations frequently, doesn’t mean that they are good at talking about it and it certainly doesn’t mean that they are not willing to cut corners in order to drive their agenda forward.

The questions you need to ask are

  • Have there been family discussions taking place before the actual decision was made “to put him to sleep”? If there haven’t been any Family discussions, the Intensive Care team is probably in breach of policies and legislations, let alone not respecting basic human rights
  • Did your Family member know what was happening? Has any of your Family or the Patient himself been involved in any decision making about whether they want to live or die?

Having only 25% of lung capacity working is certainly not a good starting point, however that doesn’t necessarily mean that your Family member needs to be put to sleep straight away.

Often, what happens is that the Intensive Care team sees a quick death, as an “easy way out” of the dilemma and Families are being “sold” on the idea that death is in “the best interest” of a critically ill Patient, whereas in reality death is “the best interest” for the Intensive Care team, because they have many competing interests such as

  • Wanting to have an empty bed in Intensive Care for another admission
  • The perceived non- financial viability of your Family member’s Intensive Care stay
  • Wanting to free up staff for the next admission
  • Research interests. Your Family member may not fall into a research category and the Intensive Care team has a bigger interest in treating other Patients that fall into a research category and therefore attract 6, 7 or 8 figure funding

In the meantime read the following articles that shed more light on the decision making process around end of life and/or withdrawal or limitation of treatment.

 

Also read our advice regarding Family meetings with the Intensive Care team

Also check out our “blog” and the “Your questions answered” section for more tips, strategies and for more questions answered.

But if you can please specify whether your Family member is dead already or not, I can certainly point you in the right direction about the options!

Thank you& Kind Regards

Your Friend!

Patrik Hutzel

How can you  further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control, PERACE OF MIND and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE reports you’ll also discover

  • how to ask the doctors and the nurses the right questions
  • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
  • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
  • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
  • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
  • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
  • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s your questions answered and I’ll see you again in another update next week!

Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Sincerely, your Friend
Patrik Hutzel

Related Articles:

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Podcast interview with Dr Margaret Ngu, founder of TRANSFORMATIONAL MEDICINE AUSTRALIA http://intensivecarehotline.com/podcast-interview-with-dr-margaret-ngu-founder-of-transformational-medicine-australia/ http://intensivecarehotline.com/podcast-interview-with-dr-margaret-ngu-founder-of-transformational-medicine-australia/#comments Sun, 06 Apr 2014 21:00:04 +0000 http://intensivecarehotline.com/?p=6415 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+Podcasts/Podcast+Dr+Ngu.wav In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Dr Margaret Ngu, founder of TRANSFORMATIONAL MEDICINE AUSTRALIA In this episode of the INTENSIVCAREHOTLINE.COM podcast Patrik interviews Dr Margaret Ngu, the founder of Transformational Medicine Australia. Dr Ngu has practiced Transformational medicine for more than 28 years. In her contribution to the bridging of mainstream and alternative […]

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In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Dr Margaret Ngu, founder of TRANSFORMATIONAL MEDICINE AUSTRALIA


In this episode of the INTENSIVCAREHOTLINE.COM podcast Patrik interviews Dr Margaret Ngu, the founder of Transformational Medicine Australia. Dr Ngu has practiced Transformational medicine for more than 28 years. In her contribution to the bridging of mainstream and alternative medicine and in bringing organisations on both sides to come together, she has given lectures and workshops overseas and convened the first three Australasian Conferences in Integrative Medicine .

You can find Dr Ngu’s website here http://transformationalmedicine.com/

In this episode of the INTENSIVECAREHOTLINE.COM podcast you’ll find

  • Why and how Dr Ngu has discovered a “truer form of healing” for now more than 28 years
  • Why Illnesses and body symptoms are an awakening for a person to their own journey and why it’s a call for growth, change& transformation
  • Why Traditional medicine is not taking those things into consideration and what to do about it
  • Why every human being is a mind, soul, body and spiritual being and why it’s so important that we recognise it
  • How we can work towards healing
  • Traditional medicine and the conventional approach is suppressing symptoms rather than looking at the holistic picture
  • How Transformational Medicine is looking at the holistic and bigger picture and why and how a person can grow even when they are very sick
  • Why a clinical environment and the “invisibility as a Patient” in a hospital is counterproductive to healing and personal growth
  • Some illnesses that we develop go back to childhood and even to times when we were a foetus in our mother’s womb
  • Why hospitals are build for doctors, for nurses and for the system and not for Patients and their Families
  • Why it’s so important that we find meaning in suffering and illness
  • How mind, body and soul connect even in end of life situations
  • Why it’s so important to find awareness, meaning , purpose, significance and your own path in life
  • Your own purpose in life is a prevention of disease and sickness and optimising your life for your  life calling sends you on the path to personal growth
  • Finding your purpose in life gives you energy of love, power and incredible wisdom
  • Your purpose in life sets you free and aligns with who you truly are
  • Why the Public health  system often lacks compassion and often lacks choice
  • Patients and their Families often feel abandoned in the public sector
  • Why drugs and surgery are often the only option for palliation of symptoms in traditional medicine and how Transformational medicine is taking a different approach
  • A more holistic approach for treatment is needed with a bigger focus on home care www.intensivecareathome.com.au
  • Pain management for awareness and completion
  • Why entering into pain is a way to find the “hidden gem” to growth, spirituality and completion of a life cycle
  • How facing pain can be a way to peace and calm
  • Why End of life care is a tremendous privilege and needs to be celebrated
  • Why a personal transformation can even happen in an End of Life situation and why it is important on a personal and even Family level
  • Palliative Care Australia has recently issued a media release with compelling stats that 75% of Australians want to die at home yet less than 20% do
  • Patrik and Dr Ngu discuss the implications of those figures and how Hospitals and Health services need to change in order to create services that can actually facilitate those wishes of the Australian public
  • Why health consumers should not “trust in limitation” which is often the prevalent mindset in public health
  • Why End of Life situations are poorly handled in hospitals and what the alternatives are www.intensivecareathome.com.au

 

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How LONG does it take to WAKE UP after an induced coma? http://intensivecarehotline.com/how-long-does-it-take-to-wake-up-after-an-induced-coma/ http://intensivecarehotline.com/how-long-does-it-take-to-wake-up-after-an-induced-coma/#comments Sun, 06 Apr 2014 09:00:54 +0000 http://intensivecarehotline.com/?p=6410 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+to+wake+up+after+induced+coma.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of your questions answered and in last week’s episode I answered another question that our readers ask quite frequently and the question was “How long can a critically ill Patient be on a ventilator with a Tracheostomy in Intensive Care?” You can check it out here.

In this week’s episode of your questions answered, I answer another question that many of our readers want to know about, if their loved one is critically ill in Intensive Care and in this week I want to answer “How long does it take to wake up after an induced coma?”

If your critically ill loved one has been admitted to Intensive Care and if your critically ill loved one is or has been in an induced coma, you have of course been wondering “How long does it take to wake up after an induced coma?”

It’s a great question to ask and after all it’s a question you would want to know the answer to, especially since you are feeling rather helpless in such a stressful, difficult, challenging and overwhelming situation such as having a loved one critically ill in Intensive Care!

So let’s get to the meet of the question and let’s get to look at the answers.

If your critically ill loved one is or has been in an induced coma and has been ventilated with a breathing tube, it can be rather normal that your critically ill loved one isn’t waking up straight away. There sometimes can be a delay in waking up because of

  • The amount and the drugs given for sedation and opiates(pain medication such as Morphine and Fentanyl) whilst your critically ill loved one is in the induced coma
  • The reason why your critically ill loved one has been in an induced coma; i.e. an induced coma for head or brain injuries is generally speaking more difficult to come out of, compared to an induced coma for “straight forward” surgery or for a less acute and “soft” admissions
  • The length of the induced coma- generally speaking, the longer the induced coma the more likely it is to have a delay in “waking up”
  • “waking up” is generally speaking a process and not an event that you can compare to switching on a light with a dimmer rather than with a light switch
  • Your critically ill loved one’s age might be a factor, generally speaking, with increasing age, the higher the risk of going through a “delay” when “waking up” and coming out of the induced coma
  • Another risk factor is severe or heavy drug and alcohol abuse. If your critically ill loved one is using drugs and/or alcohol it’s more likely that when induced into a coma that a lot more sedative and opiate drugs are being used compared to a Patient who doesn’t use drugs and/or drinks alcohol. When “waking up” and coming out of the induced coma, your critically ill loved one has a higher chance of being confused and agitated, sometimes they may even be aggressive

Let’s break it even further down and look at time frames.

1.       Your critically ill loved one is a “Straight forward” and/or “soft” admission to Intensive Care

If your critically ill loved one is a “straight forward” admission to Intensive Care after elective or planned surgery or is a “soft” admission to Intensive Care for a medical emergency on a ward etc… your critically ill loved one should come off the ventilator/ respirator and out of the induced coma relatively quickly within 12- 72 hours!

In those circumstances, your critically ill loved one should be on short acting sedatives, such as Propofol(Diprivan). Propofol(Diprivan) is a sedative that is widely used in Intensive Care to put Patients asleep and it is used as a short acting sedative, meaning that when switched off, your critically ill loved one should “wake up” relatively quickly.

That can still mean that your critically ill loved one can be confused after the induced coma.

2.       Your critically ill loved one has been in an induced coma and ventilated for 3- 7 days

If your critically ill loved one is a more complicated admission to Intensive Care and is more unstable, such as after a car accident or after major surgery where complications occurred or if your critically ill loved one sustained a head or brain injury or had a heart attack or cardiac arrest, then the breathing tube, the ventilator/ respirator and the induced coma might be required for more than 72 hours and if your loved one is stable and progressing, breathing up on the ventilator/ respirator with the support from the ventilator/ respirator being reduced, then again, your critically ill loved one should be able to come off the ventilator/ respirator after the sedation and the opiates(pain medication) have been removed and minimized.

By removing, weaning and minimizing the drugs that keep your critically ill loved one in the induced coma, your critically ill loved one should slowly but surely waking up. This at times can take time, because just as I have explained in number one, where your critically ill loved one may be sedated with short acting sedatives such as Propofol, the longer sedation for the induced coma is required, the more likely it is that a longer acting sedative such as Midazolam(Dormicum/Hypnovel)) is used. Midazolam is a Benzodiazepine and the longer a Benzodiazepine is used, the higher the risk and the likelihood that your critically ill loved one is getting addicted to it. Therefore, getting your critically ill loved one out of the induced coma, might have some challenges, such as withdrawal symptoms and therefore a gradual weaning off the Midazolam might delay “waking up”.

The same applies to the opiates(pain medication) that are given during an induced coma such as Morphine, Fentanyl or sometimes Ketamine. Those drugs can be addictive as well and just like with Midazolam, the longer your critically ill loved one has been receiving those drugs, the higher the chance to go through a withdrawal.

Again, coming out of the induced coma and off the ventilator/ respirator after more than 72 hours of ventilation and an induced coma might be a little bit more difficult, because as a rule of thumb, the longer ventilation and the induced coma is required, the higher the risk that complications and/or delays occur of course.

So, once again, if your critically ill loved one is stable, can open their eyes, can follow commands, is waking up and has shown strength to breathe by themselves there should be no reason that they can’t be taken off the ventilator after 3-7 days, generally speaking, even if your critically ill loved one is still a little confused, agitated and/or aggressive.

3.       Induced coma and ventilated for more than 7 days

If your critically ill loved one has been in Intensive Care for more than one week now and has been in an induced coma and has been ventilated for more than one week by now, you’re probably wondering and you are more importantly worried when your loved one will finally come out of the induced coma and can come off the ventilator.

Just like in number 2. the longer your critically ill loved one has been in an induced coma, the higher the risk of your critically ill loved one going

  • Through a delay in “waking up”
  • Through a phase of confusion, agitation and even aggression due to the side effects of the sedatives and opiates and due to possible or likely withdrawal from the sedatives and opiates

As a general rule of thumb, you need to be patient. Even if your critically ill loved one has finally come out of the induced coma, you might experience that your critically ill loved one is confused, agitated, drowsy or aggressive. And you’re probably shocked and maybe even embarrassed by what you see.

It’s OK. Know that it’s nothing unusual and it happens all the time in Intensive Care. Also know that many Patients can leave Intensive Care whilst they are still confused as long as they are stable.

What you also need to know is that most critically ill Patients don’t remember their time in Intensive Care, so don’t worry too much about the confusion and agitation if that’s what your critically ill loved one experiences.

Now, if after one week of ventilation and an induced coma the Intensive Care team still doesn’t feel confident to take out the breathing tube, they may suggest to insert a Tracheostomy.  Before they actually suggest a Tracheostomy they should try and get your loved one out of the induced coma first and if your loved one is “waking up” and is cooperative and can breathe, the Intensive Care team should remove the breathing tube and give your critically ill loved one “a fair go” first to find out whether your loved one can breathe without a breathing tube and without the ventilator/ respirator.

If that fails, then the Intensive Care team would have a fair point to suggest a Tracheostomy, but once again that shouldn’t be brought up before or after at least 7-10 days of ventilation. And again it shouldn’t be done until the Intensive Care team is certain that there is no other alternative.

And if you still feel like you and your Family have little to no PEACE OF MIND, no power, control and influence and if you still feel like the Intensive Care team is keeping you at arm’s length, you need a quick in depth education that gives you PEACE OF MIND, control, power and influence!

How do you do that and how can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

In your FREE report you’ll also discover

  • How to ask the doctors and the nurses the right questions
  • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
  • How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
  • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
  • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
  • You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
  • How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Related Articles:

For more information regarding Tracheostomy, ventilation and induced coma check out our related Articles

 

 

How LONG does it take to WAKE UP after an induced coma? is a post from: INTENSIVE CARE HOTLINE

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How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care! http://intensivecarehotline.com/how-to-get-peace-of-mind-more-control-more-power-and-influence-if-your-critically-ill-loved-one-is-dying-in-intensive-care/ http://intensivecarehotline.com/how-to-get-peace-of-mind-more-control-more-power-and-influence-if-your-critically-ill-loved-one-is-dying-in-intensive-care/#comments Mon, 31 Mar 2014 08:00:04 +0000 http://intensivecarehotline.com/?p=6148 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+get+peace+of+mind%2Ccontrol%2Cpower%26influence+if+your+critically+ill+loved+one+is+dying+in+ICU!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

In last week’s blog I’ve shown you “5 simple habits that help you to have control, power and influence whilst your loved one is critically ill in Intensive Care!” You can read, watch or listen to last week’s update here.

In this week’s blog I want to show you “How to get peace of mind, more control, more power and influence if your critically ill loved one is dying in Intensive Care!”

Today, I want to talk about a topic that most people think it’s difficult to talk about and a lot of people shy away from talking about it in the first place. For most people it’s very distressing, very disturbing, hard to face, overwhelming, frustrating and talking about the topic of death of a loved one means we need to face our own vulnerability and often our own mortality.

Let’s look at the good news as well

Let’s start with the good news though. The good news is that death is part of life and we need to celebrate both occasions, life and death. We also need to celebrate birth and death. To be here on this planet alive is a miracle after all. The sooner we accept and also respect that death is part of life, the sooner we all have a chance to have peace of mind, more control, power and influence in those situations!

The sooner we realize that death is part of life the easier it gets for us to accept that we are all mortal and that we all inevitably go in the same direction.

That doesn’t mean that when dealing with the inevitable such as when we are faced with the death of a loved one in Intensive Care that we need to “celebrate” the occasion. However by looking at the situation differently and by changing the things that you can change in such a challenging situation you can achieve peace of mind in this often “once in a lifetime” experience.

The tension, the drama, the discussions and the fight for life

Most end of life situations in Intensive Care involve a fair amount of tension, drama, discussions and fighting for and holding on to life.

And that’s good news. We don’t want to waste a precious life and we don’t want to stop or limit treatment on someone who has a chance to live.

However, what about the situations where death of your critically ill loved one is inevitable and where death is imminent?

That’s a great question to ask and first of all let’s establish that generally speaking 99% of Families of critically ill Patients in Intensive who are dealing with an end of life situation of their loved one feel like they have no control, no power and no influence, let alone peace of mind!

Those Families feel like the very life of their critically ill loved one is slipping through their fingers and there is nothing they can do about it. Those Families feel overwhelmed, frustrated and they very rarely ask the most important question in those often “once in lifetime” situations, which is “How can I have peace of mind, more control, more power and more  influence in an end of life situation?”

It’s a unique and a “once in a lifetime” situation

At the end of the day the end of life situation that you and your Family are dealing with is unique and is also a “once in lifetime” situation. You don’t want to get it wrong and you don’t want to leave the end of life situation and the death of your critically ill loved one in Intensive Care with a bitter taste in your mouth and without peace of mind. You also don’t want to make the wrong decisions and you certainly don’t want to be at the mercy of the Intensive Care team.

The reality and the fact of the matter is that if you and your Family have been told that your critically ill loved one is going to die, your world is falling apart and you feel once again without power, without control and without any influence whatsoever. Peace of mind is not even on your radar…

Before I go on about “How you can have more control, power, influence and peace of mind in an end of life situation” I hope that you and your Family have done your own independent research and you also have made up your own mind whether the Intensive Care team is really telling you the truth about whether death is the only perceived option for your critically ill loved one and that there is nothing else that the Intensive Care team or you and your Family can do.

If you are unclear, confused or in doubt whether the Intensive Care team is telling you the truth check out these articles here so that you can gather more information, wisdom and insight and also gain more control, power and influence in your challenging and difficult situation. The reality is that the Intensive Care team may not have told you the truth and they may simply press forward with their agenda by simply telling you that your critically ill loved one is going to die.

Related Articles:

  • The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!
  • Why would the Intensive Care team have an agenda?

    I’m glad you’ve asked. There are so many things happening “behind the scenes” in Intensive Care that you simply have no idea about and it’s critical that you quickly educate yourself about what’s happening “behind the scenes” in Intensive Care. Because the Intensive Care team may simply position your critically ill loved one’s prognosis and diagnosis depending on what’s happening “behind the scenes” and also depending on their interests and those interests may not necessarily depend on the clinical facts and they may depend more on things like the financial interests, research interests, bed status and bed pressures in Intensive Care as well as the internal politics, power play, the intrigue and the psychology in Intensive Care.

    In order to do your own research and in order to get that critical “behind the scenes” view and insights you have certainly come to the right place at INTENSIVECAREHOTLINE.COM

    Check out our FREE articles on our blog and on our “your questions answered” section for tips, strategies and for what’s happening “behind the scenes”! Those sections will help you to make up your own mind, whilst looking “behind the scenes” in Intensive Care.

    If you have come to the conclusion that your critically ill loved one is inevitably dying, you now do want to have peace of mind, control, power and influence, because you and your Family should be directing and orchestrating the end of life situation. Most Intensive Care Units however don’t want to give you control, power and influence and they don’t want you to interfere in their decision making process even in an end of life situation. After all the Intensive Care team knows best…

    Never assume that the Intensive Care team “knows what’s best”

    The unfortunate reality is that I have seen far too many end- of life situations in Intensive Care, where an end of life situation has been called far too prematurely by the Intensive Care team and where Families haven’t been told the truth and where a “withdrawal of life support” has been suggested prematurely by the Intensive Care team, because of the many competing interests in Intensive Care.

    The next step then often involves the “timing” of the end of life situation. Here, once again, the Intensive Care team then often wants to have “the bed empty” as quickly as possible, because the next admission is not far away. The Intensive Care team will also have in mind the massive costs for an Intensive Care bed and they therefore want to have an empty bed as quickly as possible.

    But what about your and your Family’s needs? Do you think that your and your Family’s needs are met if an end of life situation is rushed or hastened? Do you think that if your critically ill loved one is in an end of life situation that you should have some input?

    I have seen many end of life situations in Intensive Care where death has been rushed, for many reasons, but mainly to suit the Intensive Care team’s agenda and mainly to suit their needs rather than looking at your and your Family’s needs and your peace of mind.

    Most families of critically ill Patients in Intensive Care don’t ask how they want to have the end of life situation of their loved one to look like. They often assume that the Intensive Care team “knows best”.

    Always be involved in the decision making process, irrespective of the situation you are facing and don’t be intimidated by the Intensive Care team’s perceived power

    In more than 15 years Intensive Care nursing in three different countries I have found that if you leave the decision making to the Intensive Care team in end of life situations, you’d be pretty disappointed and you may well leave with bitter feelings and anger rather than with peace of mind.

    Here are some actions steps that will help you to achieve more piece of mind, control, power and influence in an end of life situation

    • Have you thought about asking for more time in the end of life situation? Maybe you and your Family need another 48-72 hours to come to terms with losing your critically ill loved one
    •  Have you thought about whether there are any key people that may want to see your dying loved one, such as relatives coming in from overseas or interstate?
    • Think about how the Intensive Care team can provide a private and dignified end of life situation for you, your Family and your critically ill loved one and simply ask for it. Don’t let a limited mindset of the Intensive Care team hold you back. Just because the Intensive Care team says something can’t be done or can’t be organized doesn’t mean that they can’t. You just need to keep asking for it and you just can’t take “No” for an answer
    • Is your critically ill loved one in a quiet and peaceful area in the Intensive Care Unit?
    • Does your critically ill loved one and your Family need a quiet side room for their final hours?
    • Are there any religious, spiritual and/or cultural things that you and your Family want?
    • Is there anything else that you want in this end of life situation that would help you and your Family to get peace of mind?
    • Do you and your Family want to be at the bedside at the time of death or would you rather not be present during the time of death?
    • Do you want your critically ill loved one to die at home? Again, I have seen many Families who would have wished for their loved one to go home and approach their end of life at home. Some countries have adopted these practices and in Germany, Austria, Switzerland and in Australia some Patients can approach their end of life in their own home. Check out INTENSIVECAREATHOME.COM.AU for more information
    • Once again and I can’t stress it enough, is your critically ill loved one really dying or is the Intensive Care team “selling” to you that death is the only option?

    You and your Family are much more powerful than you think you are

    Don’t let the Intensive Care team put pressure on you by them saying “by 10pm tonight we’re going to stop treatment”. Don’t assume that they hold all the decision making power. They certainly do hold all the decision making power if you let them.

    If you want to have peace of mind, control, power and influence in an end of life situation you need to make that clear to the Intensive Care team and you need to ask for what you want.

    Once again, in more than 15 years Intensive Care Nursing in three different countries I have found  that if you and your Family can direct the end of life situation you will have peace of mind, control, power and influence.

    Just because your critically ill loved one is in a busy and noisy Intensive Care Unit doesn’t mean that the Intensive Care Unit can’t organize a quiet and peaceful side room for your critically ill loved one and for you. You certainly don’t want to be exposed in a busy Intensive Care during such a private and hopefully dignified situation.

    And also, just because your critically ill loved one is in Intensive Care doesn’t mean that they can’t go home during their final days. Check out INTENSIVECAREATHOME.COM.AU for more information!

    If you keep asking for the things that you want- and don’t be shy to do so and don’t be intimidated by the Intensive Care team’s perceived power- you will have peace of mind, control, power and influence.

    How can you  further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions
    •  the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
      • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     

    Related Articles:

    How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

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    ]]> http://intensivecarehotline.com/how-to-get-peace-of-mind-more-control-more-power-and-influence-if-your-critically-ill-loved-one-is-dying-in-intensive-care/feed/ 0 http://youtu.be/4QSHTESlQbs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+get+peace+of+mind%2Ccontrol%2Cpower%26influence+if+your+critically+ill+loved+one+is+dying+in+ICU!.mp3 - Hi, http://youtu.be/4QSHTESlQbs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+get+peace+of+mind%2Ccontrol%2Cpower%26influence+if+your+critically+ill+loved+one+is+dying+in+ICU!.mp3 Hi, it’s Patrik Hutzel from INT... intensiv yes HOW LONG can a critically ill Patient be on a VENTILATOR with a TRACHEOSTOMY in Intensive Care? http://intensivecarehotline.com/how-long-can-a-critically-ill-patient-be-on-a-ventilator-with-a-tracheostomy-in-intensive-care/ http://intensivecarehotline.com/how-long-can-a-critically-ill-patient-be-on-a-ventilator-with-a-tracheostomy-in-intensive-care/#comments Sun, 30 Mar 2014 08:00:23 +0000 http://intensivecarehotline.com/?p=6145 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/HOW+LONG+can+a+critically+ill+Patient+be+on+a+ventilator+with+a+Tracheostomy+in+Intensive+Care-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    HOW LONG can a critically ill Patient be on a VENTILATOR with a TRACHEOSTOMY in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

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    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered another question from one of our readers and the question last week was “My son has Diffuse axonal brain damage and now they want to remove his Tracheostomy! Help!” You can read, watch or listen to last week’s episode here.

    In this week’s episode of your questions answered, I answer a question that many of our readers want to know about if their loved one is critically ill in Intensive Care and in this week I want to answer “How long can a critically ill Patient be on a ventilator with a Tracheostomy in Intensive Care?”

    Any topic that’s related to ventilation and Tracheostomy in Intensive Care seems to bring up a ton of questions, as there is understandably a lot of fear, uncertainty and frustration around the issues that come with ventilation and Tracheostomy in Intensive Care.

    Many Families of critically ill Patients in Intensive Care approach INTENSIVECAREHOTLINE.COM in order to have their questions answered around their critically ill loved one’s situation in Intensive Care, as well as it relates to breathing tubes, induced coma and Tracheostomy in Intensive Care! If you have a specific question about your critically ill loved one’s situation in Intensive Care you can send me an email to support@intensivecarehotline.com and I’ll answer your question as well!

    If you have come to this website to look for advice as it relates to your critically ill loved one’s situation in Intensive Care and their ongoing ventilator dependency and their Tracheostomy in Intensive Care, there’s a few things I want to shed light on in order to answer your question!

    The longer your critically ill loved one stays on the ventilator with Tracheostomy, the more difficult it gets

    If your critically ill loved one has had a Tracheostomy for ongoing ventilator dependency in Intensive Care and is still not off the ventilator, after many days, weeks or even months, the reality is that the longer it takes for your critically ill loved one to be weaned off the ventilator the harder and the more difficult it generally gets.

    The unfortunate reality often is that the ventilator dependency is often a psychological dependency and the reality also is that Intensive Care is not the right environment to wean somebody off the ventilator, but I’ll come to that later and I’ll shed light on the right environment.

    As a rule of thumb, you need to know that after a Tracheostomy has been inserted in Intensive Care, most of the time the weaning process should start the next day unless there are any contraindications, such as ongoing haemodynamic, respiratory or neurological instability. Haemodynamic instability may show up as low or high blood pressure and/or irregular heart rhythm, respiratory instability may show up as in having difficulties breathing off the ventilator and a neurological instability may show up in severe and traumatic head injuries or during seizures.

    All other things being equal and stabile, there should be no reason why weaning off the ventilator can’t be commenced the very next day after a Tracheostomy has been inserted.

    Weaning off the ventilator starts with a couple of hours off ventilation with increasing frequency

    Normally, the weaning process should start with taking your critically ill loved one off the ventilator for a couple of hours as a starting point and increase the frequency every day and as tolerated. The goal here is to have your critically ill loved one off the ventilator during the day in a few days and off the ventilator completely within 1-2 weeks. Of course, it all depends and if your critically ill loved one is unstable then this may not be achieved within the mentioned time frame of 1- 2 weeks.

    In the ideal world, once your critically ill loved one can breathe without the ventilator and after the Intensive Care team and/or the speech pathologist has established that your critically ill loved one can swallow, breathe and cough then the Tracheostomy can be removed. After your critically ill loved one has come off the ventilator a discharge to the ward may even occur with the Tracheostomy still in place and the Tracheostomy may be removed on the ward.

    In case your critically ill loved one is struggling to come off the ventilator with a Tracheostomy and if after many weeks or even many months in Intensive Care, your critically ill loved one is depressed, has no Quality of Life, has no or very little privacy and dignity and is just generally sick of being at the mercy of other people, we need to look at some of the issues closer.

    Long-term ventilator dependency and Tracheostomy in Intensive Care comes with its unique challenges and generally speaking, the longer your critically ill loved one is ventilator dependent in such a restrictive, depressing and inhibiting environment such as Intensive Care, the harder and the more difficult and challenging it gets to wean your loved one off the ventilator.

    There is no time limit for your loved one to be ventilated with Tracheostomy

    To answer the question that we set out to answer initially, a Patient with a Tracheostomy who’s ventilator dependent can stay on a ventilator forever. There is no such thing as a time limit.

    However, as I have mentioned before, the longer the ventilator dependency with Tracheostomy in the inhibiting and depressing environment that is Intensive Care, the more difficult it gets to get your critically ill loved one off the ventilator, since there is often a vicious cycle at play with the ventilator dependency triggering depression and the depression triggering the ventilator dependency, especially if your loved one had a few failed attempts to be weaned off the ventilator. On top of that there is often a disturbed day and night rhythm, with a lack of sleep and sleep deprivation in a busy, noisy and unpleasant environment!

    Your critically ill loved one generally gets very frustrated, depressed, even angry and the longer the stay in Intensive Care and the longer the dependency on the Intensive Care team, the more frustrating the experience gets for all parties involved, your critically ill loved one, for the Intensive Care team and for you and your family.

    Furthermore, the experience of having a loved one critically ill in Intensive Care on a ventilator with Tracheostomy also increases the likelihood of your critically ill loved one to catch an infection, due to the Intensive Care environment with lots of bugs flying around and also because of the depression and frustration.

    So what’s the way out of the dilemma?

    That’s a great question to ask and generally speaking there are a few things you need to know, understand and things you can implement from your end in order to improve the situation such as

    • motivate and inspire your loved one and bring in some Family photos
    •  Other practical steps would be to look at continuity of care such as
    • having regular and experienced nursing staff looking after your critically ill loved one(some units have a tendency to let their junior staff or agency staff look after their long-term Patients, as the more experienced staff tend to look after more acutely unwell Patients)
    • making sure your critically ill loved one is getting natural daylight such as having visits outside as soon as their condition allows
    • think about whether your loved one can get a quiet room with natural daylight or is your loved one exposed in the middle of a busy unit with no natural daylight?
    • make sure that the Intensive Care team are on top of things, again some units have the tendency to almost neglect their long-term Patients, because the staff are getting frustrated as well
    • ask the Intensive Care team whether your loved one might be better off with antidepressants in the interim. Antidepressants are not a long term solution though
    • make sure that your critically ill loved one gets regular showers and washes and gets out of bed on a regular basis
    • no matter how difficult the situation, stay positive, your critically ill loved one will feel the positive vibes coming from your family
    • the longer your loved one stays in ICU the higher the risk of your loved one catching an infection, therefore a side room with no exposure to other Patients and therefore bugs might be an advantage as well

    As far as your critically ill loved one’s Tracheostomy goes, again it’s nothing unusual in Intensive Care to see Patients having failed attempts to wean them off the ventilator and the Tracheostomy for the reasons I that mentioned above.

    Depending on where you live, you might also consider external specialized services such as INTENSIVE CARE AT HOME. There are services available in countries such as Germany, USA and Australia who focus on weaning long-term ventilated Patients in the home as a genuine alternative to a long-term stay in Intensive Care, generally with a focus on Quality of Life for Patients and their Families. You can find more information at http://intensivecareathome.com.au

    That also leads me to where I believe the right place is for any long-term ventilated Patient with Tracheostomy is and that is their own home.

    Because I have worked with long-term ventilated Adults& Children with Tracheostomy in their own home as a genuine alternative to a long-term stay in Intensive Care, you wouldn’t believe how much Patients and their Families blossom once they are out of Intensive Care and have gone home with specialized services such as INTENSIVE CARE AT HOME. Those services provide a genuine alternative to a long-term stay in Intensive Care and nothing, but nothing beats home, especially for somebody who has been in Intensive Care for long periods of time.

    The harsh reality also often is that Intensive Care Units don’t want you to get too involved in their decision making process. However if you are finding that things are not improving then it’s time that you start questioning the Intensive Care team’s approach and then it’s time that you take charge, take control, have power and influence!

    The unfortunate reality is also often that if your critically ill loved one is ventilator dependent with Tracheostomy that the ICU thinks that if your critically ill loved one is not progressing then it might be “in the best interest” of your critically ill loved one to “limit” or “withdraw treatment”.

    Related Articles:

     

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover

    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
    • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Related Articles

     

     

     

     

    HOW LONG can a critically ill Patient be on a VENTILATOR with a TRACHEOSTOMY in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

    The post HOW LONG can a critically ill Patient be on a VENTILATOR with a TRACHEOSTOMY in Intensive Care? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/how-long-can-a-critically-ill-patient-be-on-a-ventilator-with-a-tracheostomy-in-intensive-care/feed/ 0 http://youtu.be/te8ulwjVb20 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/HOW+LONG+can+a+critically+ill+Patient+be+on+a+ventilator+with+a+Tracheostomy+in+Intensive+Care-.mp3 - Hi, http://youtu.be/te8ulwjVb20 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/HOW+LONG+can+a+critically+ill+Patient+be+on+a+ventilator+with+a+Tracheostomy+in+Intensive+Care-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered another question from one of our readers and the question last week was “My son has Diffuse axonal brain damage and now they want to remove his Tracheostomy! Help!” You can read, watch or listen to last week’s episode here (http://intensivecarehotline.com/my-son-has-diffuse-axonal-brain-damage-and-now-they-want-to-remove-his-tracheostomy-help/). In this week’s episode of “your questions answered”, I answer a question that many of our readers want to know about if their loved one is critically ill in Intensive Care and in this week I want to answer “How long can a critically ill Patient be on a ventilator with a Tracheostomy in Intensive Care?” Any topic that’s related to ventilation and Tracheostomy in Intensive Care seems to bring up a ton of questions, as there is understandably a lot of fear, uncertainty and frustration around the issues that come with ventilation and Tracheostomy in Intensive Care. Many Families of critically ill Patients in Intensive Care approach INTENSIVECAREHOTLINE.COM in order to have their questions answered around their critically ill loved one’s situation in Intensive Care, as well as it relates to breathing tubes, induced coma and Tracheostomy in Intensive Care! If you have a specific question about your critically ill loved one’s situation in Intensive Care you can send me an email to support@intensivecarehotline.com (mailto:support@intensivecarehotline.com) and I’ll answer your question as well! If you have come to this website to look for advice as it relates to your critically ill loved one’s situation in Intensive Care and their ongoing ventilator dependency and their Tracheostomy in Intensive Care, there’s a few things I want to shed light on in order to answer your question! The longer your critically ill loved one stays on the ventilator with Tracheostomy, the more difficult it gets If your critically ill loved one has had a Tracheostomy for ongoing ventilator dependency in Intensive Care and is still not off the ventilator, after many days, weeks or even months, the reality is that the longer it takes for your critically ill loved one to be weaned off the ventilator the harder and the more difficult it generally gets. The unfortunate reality often is that the ventilator dependency is often a psychological dependency and the reality also is that Intensive Care is not the right environment to wean somebody off the ventilator, but I’ll come to that later and I’ll shed light on the right environment. As a rule of thumb, you need to know that after a Tracheostomy has been inserted in Intensive Care, most of the time the weaning process should start the next day unless there are any contraindications, such as ongoing haemodynamic, respiratory or neurological instability. Haemodynamic instability may show up as low or high blood pressure and/or irregular heart rhythm, respiratory instability may show up as in having difficulties breathing off the ventilator and a neurological instability may show up in severe and traumatic head injuries or during seizures. All other things being equal and stabile, there should be no reason why weaning off the ventilator can’t be commenced the very next day after a Tracheostomy has been inserted. Weaning off the ventilator starts with a couple of hours off ventilation with increasing frequency intensiv yes
    5 SIMPLE HABITS that help you to have CONTROL, POWER and INFLUENCE whilst your loved one is critically ill in Intensive Care! http://intensivecarehotline.com/5-simple-habits-that-help-you-to-have-control-power-and-influence-whilst-your-loved-one-is-critically-ill-in-intensive-care/ http://intensivecarehotline.com/5-simple-habits-that-help-you-to-have-control-power-and-influence-whilst-your-loved-one-is-critically-ill-in-intensive-care/#comments Mon, 24 Mar 2014 08:00:28 +0000 http://intensivecarehotline.com/?p=5932 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+simple+habits+to+have+control%2C+power+and+influence+whilst+your+loved+one+is+critically+ill+in+ICU!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

    5 SIMPLE HABITS that help you to have CONTROL, POWER and INFLUENCE whilst your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post 5 SIMPLE HABITS that help you to have CONTROL, POWER and INFLUENCE whilst your loved one is critically ill in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “Five straightforward ways to improve Family satisfaction in Intensive Care!” You can read, watch or listen to last week’s update here.

    In this week’s blog I want to show you “5 simple habits that help you to have control, power and influence whilst your loved one is critically ill in Intensive Care!”

    Fear, frustration, struggle, challenge, overwhelm and vulnerability are all feelings and thoughts that you can resonate with if your loved one has been admitted to Intensive Care for critical illness!

    After all you and your Family most likely didn’t expect that you would have a Family member in Intensive Care and even if you did see it coming, it’s still a very painful, frightening, challenging and difficult situation to be confronted with! This is especially true if your critically ill loved one’s life is in danger, if they are very unstable and/or if they are facing a long-term stay in Intensive Care!

    By now you would have also discovered and noticed that the Intensive Care team doesn’t necessarily want you to get too heavily involved in what they are doing. After all the Intensive Care team has their own agenda and the Intensive Care team may position your critically ill loved one’s diagnosis and prognosis depending on their interests and depending on what’s happening “behind the scenes”.

    “Behind the scenes” is really where the Intensive Care team makes decisions and comes to conclusions on how to present your critically ill loved one’s prognosis and diagnosis to you. Those decisions and conclusions that the Intensive Care team makes are often not based on the clinical facts and realities and are more often than not based on

    • The bed situation in Intensive Care, I.e. how many other Patients are awaiting admission into scarce, expensive and precious Intensive Care beds
    • The politics, the intrigue, the power play, the psychology, the drama and the dynamics that go on “behind the scenes” that the Intensive Care team is hiding from you at any cost
    • The perceived financial viability of your critically ill loved one’s admission. I.e. if the Intensive Care thinks your critically ill loved one’s admission to Intensive Care is putting too much pressure on their budget or if they think that your critically ill loved one’s admission is not making them any money, the Intensive Care team will simply tell you that a “withdrawal or a limitation of treatment” might be “in the best interest” for your critically ill loved one
    • The perception the Intensive Care team has of you and of your Family. For example if the Intensive Care team knows that you are not demanding, if you are not asking the right questions and if you are taking everything for face value that the Intensive Care team is telling you, they will perceive you as “easy prey” and you will stand no chance to even get a glimpse about the real situation that you, your Family and your critically ill loved one are facing
    • How powerful, how much control and how much influence you and your Family have, based on whether you are intimidated by the perceived power of the Intensive Care team, based on how many and what type of questions you ask, based on whether you see yourself as equals to the Intensive Care team and also based on that you and your Family believe that you have control, power and influence irrespective of the situation that you are facing
    • Research. Yes, based on research. You’d be surprised if I tell you that medical research is a million dollar $$$ industry and most Intensive Care Units are involved in and rely on getting 6, 7 or sometimes even 8 figure funding from Universities, Pharmaceutical companies  etc… to do medical research. If you are or if you were unaware that this is a reality then you’d better listen to this because the reality is that if the Intensive Care team is telling you that a “withdrawal or a limitation of treatment” might be “in the best interest” for your critically ill loved one, they might be telling you that they are not interested in continuing treatment for your critically ill loved one because they don’t fit any of their research criteria. If on the other hand your critically ill loved one is actually going to die and the Intensive Care team is telling you that they would like to continue treatment, it may be because your critically ill loved one is fitting into a research criteria and the Intensive Care team therefore wants to continue treatment, putting your critically ill loved one through unnecessary treatment and suffering

    The good news is that irrespective of what the Intensive Care team is doing and irrespective of their positioning there are a lot of things that you can do to have control, power and influence and you can start with “5 simple habits that help you to have control, power and influence whilst your loved one is critically ill in Intensive Care!”

    Let’s look at those habits them in detail to get you off on the right path

    1.       Ask the right questions

    The grim and unfortunate reality is that 99% of Families of critically ill Patients in Intensive Care don’t ask the right questions. Their questions tend be weak in nature and they tend to be too general. In order to get a good grip on the situation you need to ask the right questions by informing and educating yourself quickly. You can do so by reading our INTENSIVECAREHOTLINE.COM  blog, you can read our “your questions answered” section and you can just go to our clinical pictures” section and click on the clinical picture that your critically ill loved one has been admitted with. Make it a habit to ask the right questions. Don’t be afraid to ask difficult and challenging questions, because they are the questions that will give you not only the most insights, but they will also give you the biggest leverage when it comes to control, power and influence in this challenging situation

     2.       Don’t be intimidated

    Another very unfortunate reality that I have encountered over and over again in more than 15 years Intensive Care nursing in three different countries is that 99% of Families of critically ill Patients are intimidated by the perceived power of the Intensive Care team. You need to stop being intimidated by the Intensive Care team right now and you need to start challenging the Intensive Care team, irrespective of how much you think you know about what’s going on. By you being intimidated by the Intensive Care team, you are basically handing over any level of control, power and influence you might have had over to the Intensive Care team on a platter…

    The question remains, how can you stop being intimidated by the Intensive Care team?

     3.       Change YOUR body language

    In order to stop being intimidated by the Intensive Care team, you and your Family need to change your body language as a starting point.

    I bet that from the minute you found out that your loved one has been admitted to Intensive Care your body language and your body posture has changed to something unhealthy like

    • Crossed arms
    • Neck and face down
    • Slumped shoulders
    • Avoiding eye contact

    Those are all signs that are normal when we are faced with a challenging situation. The challenge here is to recognize that it’s happening and then change it. I bet you feel far more powerful, in control and influential when you’ve changed your body language. And I can promise you that the Intensive Care team will notice that your body language is different. They will notice that your body language says “yes, I can deal with this challenge and I’m not intimidated by what’s happening and I’m certainly not intimidated by the Intensive Care team, because I have control, power and influence!”

    Make eye contact with the Intensive Care team at all times, look them in the eye and tell them one way or another that you are not intimidated. Your body language is so important and as some statistics and research suggests, 7% we communicate is with words and more than 70% we communicate with our body language. That’s powerful stuff if you know how to use it…

     4.       Don’t make common mistakes Families of critically ill Patients are making

    99% of Families of critically ill Patients in Intensive Care make three simple but easily avoidable mistakes when they have a loved one critically ill in Intensive Care. You can easily avoid those mistakes once you know what they are. I have written a blog post about

    The 3 most dangerous mistakes that you are making but you are unaware of, if your loved one is a critically ill Patient in Intensive Care

    Check it out so that you discover what mistakes you have been making and how you can stop making them

    5. Seek out help

    Another simple habit that you can start implementing now, that will lead you directly to control, power and influence is to seek out professional help and support. In order to get professional help, support and more insights into the world of Intensive Care so that you, your Family and your critically ill loved one have more control, power and influence in a world that was previously dominated by Intensive Care health professionals

    How can you  further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
    • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
    • You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    •  how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     

    Related Articles:

    5 SIMPLE HABITS that help you to have CONTROL, POWER and INFLUENCE whilst your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post 5 SIMPLE HABITS that help you to have CONTROL, POWER and INFLUENCE whilst your loved one is critically ill in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/5-simple-habits-that-help-you-to-have-control-power-and-influence-whilst-your-loved-one-is-critically-ill-in-intensive-care/feed/ 0 http://youtu.be/fZnJR0Hi2Cg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+simple+habits+to+have+control%2C+power+and+influence+whilst+your+loved+one+is+critically+ill+in+ICU!.mp3 - Hi, http://youtu.be/fZnJR0Hi2Cg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+simple+habits+to+have+control%2C+power+and+influence+whilst+your+loved+one+is+critically+ill+in+ICU!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve shown you “Five straightforward ways to improve Family satisfaction in Intensive Care!” You can read, watch or listen to last week’s update here. In this week’s blog I want to show you “5 simple habits that help you to have control, power and influence whilst your loved one is critically ill in Intensive Care!” Fear, frustration, struggle, challenge, overwhelm and vulnerability are all feelings and thoughts that you can resonate with if your loved one has been admitted to Intensive Care for critical illness! After all you and your Family most likely didn’t expect that you would have a Family member in Intensive Care and even if you did see it coming, it’s still a very painful, frightening, challenging and difficult situation to be confronted with! This is especially true if your critically ill loved one’s life is in danger, if they are very unstable and/or if they are facing a long-term stay in Intensive Care! By now you would have also discovered and noticed that the Intensive Care team doesn’t necessarily want you to get too heavily involved in what they are doing. After all the Intensive Care team has their own agenda and the Intensive Care team may position your critically ill loved one’s diagnosis and prognosis depending on their interests and depending on what’s happening “behind the scenes”. “Behind the scenes” is really where the Intensive Care team makes decisions and comes to conclusions on how to present your critically ill loved one’s prognosis and diagnosis to you. Those decisions and conclusions that the Intensive Care team makes are often not based on the clinical facts and realities and are more often than not based on * The bed situation in Intensive Care, I.e. how many other Patients are awaiting admission into scarce, expensive and precious Intensive Care beds * The politics, the intrigue, the power play, the psychology, the drama and the dynamics that go on “behind the scenes” that the Intensive Care team is hiding from you at any cost * The perceived financial viability of your critically ill loved one’s admission. I.e. if the Intensive Care thinks your critically ill loved one’s admission to Intensive Care is putting too much pressure on their budget or if they think that your critically ill loved one’s admission is not making them any money, the Intensive Care team will simply tell you that a “withdrawal or a limitation of treatment” might be “in the best interest” for your critically ill loved one * The perception the Intensive Care team has of you and of your Family. For example if the Intensive Care team knows that you are not demanding, if you are not asking the right questions and if you are taking everything for face value that the Intensive Care team is telling you, they will perceive you as “easy prey” and you will stand no chance to even get a glimpse about the real situation that you, your Family and your critically ill loved one are facing * How powerful, how much control and how much influence you and your Family have, based on whether you are intimidated by the perceived power of the Intensive Care team, based on how many and what type of questions you ask, based on whether you see yourself as equals to the Intensive Care team and also based on that you and your Family believe that you have control, power and influence irrespective of the situation that you are facing * Research. Yes, intensiv yes
    My son has Diffuse axonal BRAIN DAMAGE and now they want to REMOVE his Tracheostomy! Help! http://intensivecarehotline.com/my-son-has-diffuse-axonal-brain-damage-and-now-they-want-to-remove-his-tracheostomy-help/ http://intensivecarehotline.com/my-son-has-diffuse-axonal-brain-damage-and-now-they-want-to-remove-his-tracheostomy-help/#comments Sun, 23 Mar 2014 08:00:11 +0000 http://intensivecarehotline.com/?p=5927 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+son+has+Diffuse+axonal+brain+damage+and+now+they+want+to+remove+his+Tracheostomy!+Help.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    My son has Diffuse axonal BRAIN DAMAGE and now they want to REMOVE his Tracheostomy! Help! is a post from: INTENSIVE CARE HOTLINE

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    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered another of our most frequently asked questions “After weaning off a ventilator is it normal to be confused?” You can read, watch or listen to the update here.

    In this week’s episode of your questions answered, one of our reader’s Robin, from the United States has the following question regarding her son’s “My son has Diffuse axonal brain damage and now they want to remove his Tracheostomy! Help!”.

     Hi Patrik,

    My son who is 22 was in a car accident.  He was on a ventilator for about three weeks in ICU and is now breathing on his own with a Tracheostomy and is another room now.

    He has been in a coma since the accident..never induced.

    They are now weaning him off the Tracheostomy and are hoping he will breathe on his own without the Tracheostomy.  He’s a size 6 Tracheostomy.  And he is still in a coma and not responding.  He coughs, yawns, opens and closes his left eye, sleeps and awakes, feels pain, is on a feeding tube, but is not responding to commands.

    December 19, 2013 was when the accident happened and he has Diffuse Axonal Brain Damage.  I’m extremely worried about him with the Tracheostomy out.  Let me know please your comments.  Thank you for your time and God Bless.

    Dear Robin,

    thank you for your email.

    I appreciate the time you are taking to contact INTENSIVECAREHOTLINE.COM and I can feel your concerns, worries and the pain you are going through because of your son’s condition and situation.

    Brain and head injuries take time, however it is of concern that your son has never been in an induced coma and that he’s still not responding to commands after nearly two months since the accident.

    A “Diffuse Axonal Brain Damage” is certainly a big challenge and it’s known that  it can cause unconsciousness and a persistent vegetative state after head trauma.

    That’s certainly concerning as a starting point. However my experience has also shown that head and brain injuries take time to heal and you must stay positive! Just think about the recent skiing accident of the famous Formula 1 driver Michael Schuhmacher who has had a severe brain injury and is still in a coma. Head and brain injuries take a long time!

    As it relates to your son’s Tracheostomy, if he has been off the ventilator and is now spontaneously breathing with a Tracheostomy chances that he can breathe without the Trachea depend on whether he will be able to swallow and whether he can cough and can clear his airway.

    Also keep in mind that after the Tracheostomy may have come out that your son may be in a position to go to rehabilitation. Brain injuries of this severe nature may require rehabilitation after Intensive Care in order to improve his situation.

    I think that it’s certainly worthwhile trying to get him off the Tracheostomy whilst he is in Hospital. A size 6 Tracheostomy is a relatively small size and is almost a paediatric(children’s) size.

    The size however is not all that important and as I mentioned before it’s more important that he can breathe, swallow and cough.

    Also check out our “Your questions answered” section here http://intensivecarehotline.com/category/questions/ where we answer lots of questions about Tracheostomy as well as Head injuries! Also visit our “blog” section where we have more articles about how you can stay positive and other tips and strategies on how to deal with challenging situations whilst your loved one is critically ill in Intensive Care. You can find our blog here http://intensivecarehotline.com/category/blog/

     Other articles of interest for you that will help in your situation are

     

    Sincerely, your Friend

    Patrik

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover

    • how to ask the doctors and the nurses the right questions
    • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    Related Articles:

     

     

     

    My son has Diffuse axonal BRAIN DAMAGE and now they want to REMOVE his Tracheostomy! Help! is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/my-son-has-diffuse-axonal-brain-damage-and-now-they-want-to-remove-his-tracheostomy-help/feed/ 0 http://youtu.be/pm_ACpDuJFs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+son+has+Diffuse+axonal+brain+damage+and+now+they+want+to+remove+his+Tracheostomy!+Help.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE. http://youtu.be/pm_ACpDuJFs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+son+has+Diffuse+axonal+brain+damage+and+now+they+want+to+remove+his+Tracheostomy!+Help.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.CO... intensiv yes
    Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care! http://intensivecarehotline.com/five-straightforward-ways-improve-family-satisfaction-intensive-care/ http://intensivecarehotline.com/five-straightforward-ways-improve-family-satisfaction-intensive-care/#comments Mon, 17 Mar 2014 08:00:54 +0000 http://intensivecarehotline.com/?p=5522 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Five+straightforward+ways+to+improve+Family+satisfaction+in+Intensive+Care!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

    Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you How to control your emotions quickly whilst your loved one is critically ill in Intensive Care and why it’s a shortcut to control, power and influence!” You can read, watch or listen to last week’s update here.

    In this week’s blog I want to show you “Five straightforward ways to improve Family satisfaction in Intensive Care!”

    Family satisfaction in Intensive Care is hard to measure and is also hard to achieve. One might say that the majority of Patients, in fact, around 90- 95 % of all Intensive Care admissions are leaving Intensive Care alive and that’s great news! So why should those Families be dissatisfied?

    And the reality is that those Families often aren’t dissatisfied.

    But what about the situations where it’s unlikely that Families are going to be satisfied, given the sometimes difficult and heartbreaking circumstances their and their critically ill loved one are in?

    And here, I really want to look at the situations where critically ill Patients are in difficult, unpredictable and volatile situations such as

    • If they are very unstable and in very critical conditions
    • If they are in life threatening situations
    • If they are in Intensive Care for long-term treatments and long-term stays
    • when critically ill Patients approach their end of life in Intensive Care

    Everything else I believe is secondary, as most Patients and their respective Families in Intensive Care who are leaving Intensive Care alive and in a relatively short and acceptable period of time are going to have some level of satisfaction.

    The reason I do want to look at these situations in particular and how Family satisfaction can be improved is that during all of those situations that I mentioned above, the level of fear, frustration, struggle, overwhelm, vulnerability and the level of challenges Families are dealing with is huge!

    Especially during those situations the level of control, power and influence is diminished or non- existent for most or for all of those Families. Therefore, I also know from experience, after more than 15 years Intensive Care nursing in three different countries that the Intensive Care team during those situations wants to make sure that “they are pulling all the strings” and that “they are calling the shots” by not only positioning themselves, but by also positioning the diagnosis and prognosis of critically ill Patients depending on what’s happening “behind the scenes” and also depending on the politics, the intrigue and the psychology that is at play in an Intensive Care Unit.

    Because what Families of critically ill Patients don’t know most of the time is that Intensive Care Units have many other competing interests, besides treating and “curing” critically ill Patients.

    So let’s therefore look at “Five straightforward ways to improve Family satisfaction in Intensive Care!”, as they relate to the situations that I mentioned above, where Families have little or no perceived control, power and influence.

    1.       Transparency

    Transparency is paramount and yet, especially when Families and their critically ill loved ones are in situations where the situation is difficult, volatile and challenging, the Intensive Care team may not necessarily be transparent and they may only tell Families “half of the truth”. The Intensive Care team, certainly has no interest in letting Families of critically ill Patients look “behind the scenes”.

    What do I mean by that?

    A recurring theme in Intensive Care is that if the Intensive Care team is telling you and your Family that your critically ill loved one is going to die or that a “limitation of treatment” or a “withdrawal of treatment” is “in the best interest” of your critically ill loved one, the Intensive Care team’s positioning might be a direct result of competing interests such as

    • The financial interests and the perceived financial viability of your loved one’s stay and treatment in Intensive Care
    • The line up of other admissions awaiting a scarce, precious and expensive bed in Intensive Care that might directly compete with the treatment of your critically ill loved one(usually, a bed in Intensive Care never gets “cold” and never stays empty for too long)
    • The research activities and the research interests that are going on in Intensive Care. Let’s say your critically ill loved one is a long-term stay in Intensive Care and again, the Intensive Care team suggests to “limit or withdraw treatment”, the Intensive Care team might not be interested in continuing treatment, because your critically ill loved one may not fit into any research category and your critically ill loved one may therefore not “attract” 6, 7 or even 8 figure funding for research activities. The direct result is that the Intensive Care team has a much higher interest in treating Patients who fall into a research category and who attract that funding

    Therefore transparency is absolutely paramount and if you and your Family are not asking the right questions and if you are scared and intimidated by the Intensive Care team, the situation will never be transparent and your critically ill loved one may not receive the best and full treatment and you and your Family are kept at arm’s length so to speak!

    2.       Involvement in decision making

    Now the bottom line is that the Intensive Care team wants to call the shots when it comes to decision making. They often couldn’t care less about what you and your Family want.

    The Intensive Care team presents you with “facts” that they twist and turn to their liking and that’s often how they position your critically ill loved one’s prognosis and diagnosis and that’s therefore how they position themselves.

    The bleak reality is that Families of critically ill Patients are not or are very poorly positioned, because they are generally speaking so overwhelmed, frustrated and challenged by the experience of having a loved one critically ill in Intensive Care that they have really no idea how to position themselves.

    Therefore, if you and your family want to be involved in decision making, you need to work out your positioning and you need to position yourself well mentally and emotionally.

    After you’ve achieved that you need to actively participate in the decision making around the treatment your critically ill loved one is receiving or not receiving. After all it’s your loved one who’s critically ill and not the Intensive Care team’s loved one. And with the knowledge that you have by now about what’s happening “behind the scenes” in Intensive Care you have every reason to be involved in decision making!

    Don’t be intimidated by the Intensive Care team’s “perceived” power, because it’s only perceived after all and it’s not even real.

    3.       Education and engagement

    The next straightforward point to improve family satisfaction in Intensive Care is your education and engagement in the Intensive Care environment!

    Again, the Intensive Care team might be telling you about and filling you into some of the things that are happening around your critically ill loved one, however the Intensive Care team often only scratches the surface and they often don’t tell you about the details that are happening around the care and the treatment of your critically ill loved one. You and your Family therefore need to ask as many questions as possible and of course you educate yourself at our website www.intensivecarehotline.com

    The reality is that the more you know and the more and better questions that you ask, your level of power, control and influence increases, most of the time to the disliking of the Intensive Care team! And that’s cool, because you and your Family are probably sick of feeling powerless, without control and without influence!

    But if you continue doing that, you will most likely see the dynamics shift in your favour immediatley…

    4.       Genuine alternatives

    The Intensive Care team often doesn’t tell you about any alternatives that may be alternatives if your loved one is critically ill in Intensive Care.

    What do I mean by that?

    You may think that if your critically ill loved one is in Intensive Care and is critically ill that there are very few if any perceived alternatives. Wrong!

    Even though most people perceive that if a Patient requires Intensive Care there are only two options to leave ICU

    a)      A critically ill Patient recovers and leaves Intensive Care

    b)      A critically ill Patient dies and leaves Intensive Care

    But especially if your critically ill loved one is falling into the categories that I mentioned before

    • If they are very unstable and in very critical conditions
    • If they are in life threatening situations
    • If they are in Intensive Care for long-term treatments and long-term stays
    • when critically ill Patients approach their end of life in Intensive Care

    Mainly the last two categories scream for your critically ill loved one to have a genuine alternative to a stay in Intensive Care.

    If I had a Dollar for every Family and/or Patient who desperately wanted to go home during a long term stay in Intensive Care or if I had a Dollar for every Family who wanted for their loved one to go home when they were approaching their end of life, I would be a Millionaire!

    However, the good news is that in this day and age a shift towards more and better Home Care, even in high acuity areas such as Intensive Care  and even in end of life situations in Intensive Care can be achieved. Many European countries such as Germany, Austria and Switzerland have embraced the model of Intensive Home Care a long time ago and the reality is that it’s massively successful for long-term ventilated Adults& Children with Tracheostomy. Australia has followed suit and you can get more information at INTENSIVECAREATHOME.COM.AU

    Usually, transferring a long-term ventilated Patient with Tracheostomy home, is a big win, because imagine, taking your critically ill loved one home from a depressing and inhibiting environment such as Intensive Care, it’s a no brainer really. Check out INTENSIVECAREATHOME.COM.AU

    5.       Empowerment

    Last but not least, Families of critically ill Patients in Intensive Care need to empowered, they need to get involved in decision making and they need to be powerful, in control and influential! Families of critically ill Patients have been at the mercy of Intensive Care teams for far too long and it’s time to stop that and it’s time that Families of critically ill Patients get real and genuine support such as at INTENSIVECAREHOTLINE.COM where we give you the real stuff and the behind the scenes insights that you need in order to manage this challenge!

     How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions
    • Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • How to stop being intimidated by the Intensive Care team and how you will be seen as equals
    • you’ll get crucial “behind the scenes” insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    Related Articles:

    Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/five-straightforward-ways-improve-family-satisfaction-intensive-care/feed/ 0 http://youtu.be/y-m1HJ1Lr8M https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Five+straightforward+ways+to+improve+Family+satisfaction+in+Intensive+Care!.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/y-m1HJ1Lr8M https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Five+straightforward+ways+to+improve+Family+satisfaction+in+Intensive+Care!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http:/... intensiv yes
    After weaning off a ventilator is it NORMAL to be confused? http://intensivecarehotline.com/weaning-ventilator-normal-confused/ http://intensivecarehotline.com/weaning-ventilator-normal-confused/#comments Sun, 16 Mar 2014 08:00:02 +0000 http://intensivecarehotline.com/?p=5470 ) https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/After+weaning+off+a+ventilator+is+it+normal+to+be+confused_.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This […]

    After weaning off a ventilator is it NORMAL to be confused? is a post from: INTENSIVE CARE HOTLINE

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    )

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode ofyour questions answered and in last week’s episode I answered How long does it take to come off a ventilator/ respirator in Intensive Care?” You can read, watch or listen to the update here.

    In this week’s episode of your questions answered” I want to answer another one of our most frequently asked questions and the question this week is “After weaning off a ventilator is it normal to be confused?”

    If your loved one is critically ill in Intensive Care, chances are that your loved one has been on a ventilator/ respirator for any period of time and normally what goes hand in hand with ventilation and a breathing tube(endotracheal tube) is that your critically ill loved one is or was in an induced coma.

    Furthermore, what also goes hand in hand with your loved one being critically ill in Intensive Care is that you and your Family have millions of questions and not all questions may get answered by the Intensive Care team in a fashion that you may be satisfied with.

    What usually also goes hand in hand if your loved one is critically ill in Intensive Care is that you and your Family feel frustrated, fearful, stressed, overwhelmed, vulnerable and out of your comfort zone, due to the lack of control, power and influence you experience during this stressful and challenging time.

    Moreover, if your critically ill loved one has just been weaned off the ventilator and has come out of the induced coma, they may be confused.

    So, if that’s the case there is usually no need to panic, as a prolonged induced coma and mechanical ventilation on a ventilator/respirator can cause confusion, agitation and non- cooperation.

    So, let’s shed some more light on the induced coma and ventilation and the side effects of it.

    As a rule of thumb, the longer your critically ill loved one is in an induced coma and on a ventilator/ respirator the higher chances are that your critically ill loved one will wake up, come out of the induced coma, gets taken off the ventilator and is confused, agitated and even uncooperative.

    The reasons can be manyfold and are most likely to be found that during the induced coma, sedative drugs such as Propofol or Midazolam(also Hypnovel or Dormicum) and also opiate drugs(pain killer drugs) such as Morphine, Fentanyl or Ketamine are given. The combination of these drugs tend to be pretty “heavy guns” so to speak and they generally do a good job to keep your critically ill loved one comfortable on the ventilator, however by the time your critically ill loved one is “waking up” and is coming out of the induced coma the accumulation of those sedative and pain killer drugs can cause your loved one to be confused, agitated and non- cooperative.

    Prolonged surgery and head or brain injuries may delay “waking up” as well

    Furthermore, if your critically ill loved one has required prolonged surgery before the induced coma and the Intensive Care admission, the likelihood of your critically ill loved one to be confused, agitated and non- cooperative is increased again.

    Also, if your critically ill loved one has had any major brain or head injury, the likelihood and risk for confusion, agitation and non- cooperation is increased again.

    Another factor and contributor to confusion, agitation and non- cooperation after your loved one has come out of the induced coma and has been taken off the ventilator/ respirator is that if your loved one is or has been taking drugs and/ or is drinking lots of alcohol that the likelihood and risk of confusion, agitation and non- cooperation is increased due to the likely withdrawal from alcohol and/or drugs that your loved one may have used/misused before admission to Intensive Care.

    Increased age as another risk factor

    The other factor that’s increasing the risk of your loved one being confused, agitated and non-cooperative after an induced coma and after the ventilator and the breathing tube have been removed is their age. Generally speaking, the older your critically ill loved one is the higher the risk of your critically ill loved one that “waking up” is not “straight forward”.

    As a rule of thumb and from my experience in more than 15 years critical care nursing experience in three different countries, I would say that if your critically ill loved one is above the age of 70 that they have a higher risk of being confused, agitated and non- cooperation when coming out of the induced coma and when they are coming off the ventilator! If your critically ill loved one falls into the age category above 70, they may be absolutely fine and I’m only saying that age can be a factor for having difficulties in “waking up”.

    Moreover what you also need to know is that some of the sedative drugs and opiate drugs(pain killers) such as Midazolam, Morphine and Fentanyl can make your critically ill loved one addicted and the longer your critically ill loved one has been in an induced coma, the higher the risk and the likelihood that your critically ill loved one is going through a withdrawal when coming out of the induced coma. If your critically ill loved one is going through a withdrawal after the induced coma, your critically ill loved one is once again at a higher risk to be confused, agitated and non- cooperative.

    Last but not least, you may also want to know how long your critically ill loved one will be confused, agitated and non- cooperative after coming out of the induced coma and after coming off the ventilator?

    The answer: It depends.

    It depends on a number of factors including how stable or unstable your critically ill loved one is after coming off the ventilator and after coming out of the induced coma. The confusion, agitation and non- cooperation can last from a few days to one or even two weeks. Some Patients may even leave Intensive Care when they are still confused, agitated and non- cooperative.

    I know it’s easier said than done, but be patient. Sometimes the key to get through the challenge of having a loved one critically ill in Intensive Care is being patient.

    What’s really key though is that you keep asking questions and that you take charge and take control of the situation in order to have control, power and influence, because as you know by now, it’s pretty challenging seeing the Intensive Care team running the show and seeing your critically ill loved one suffer.

     How can You  leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     

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    How to control your emotions QUICKLY whilst your loved one is critically ill in Intensive Care and why it’s a SHORTCUT to control, power and influence! http://intensivecarehotline.com/control-emotions-quickly-whilst-loved-one-critically-ill-intensive-care-shortcut-control-power-influence/ http://intensivecarehotline.com/control-emotions-quickly-whilst-loved-one-critically-ill-intensive-care-shortcut-control-power-influence/#comments Mon, 10 Mar 2014 20:00:56 +0000 http://intensivecarehotline.com/?p=5328 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+control+your+emotions+quickly+whilst+your+loved+one+is+critically+ill+in+Intensive+Care!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

    How to control your emotions QUICKLY whilst your loved one is critically ill in Intensive Care and why it’s a SHORTCUT to control, power and influence! is a post from: INTENSIVE CARE HOTLINE

    The post How to control your emotions QUICKLY whilst your loved one is critically ill in Intensive Care and why it’s a SHORTCUT to control, power and influence! appeared first on INTENSIVE CARE HOTLINE.

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve asked “Is it “SEXY” for the Intensive Care team to treat your loved one who requires a long-term stay in Intensive Care?” and I shed some light on why it may not be perceived as “sexy” by the Intensive Care team to treat your critically ill loved one if they require a long-term stay in Intensive Care. You can read, watch or listen to last week’s update here.

    In this week’s blog I want to show you “How to control your emotions quickly whilst your loved one is critically ill in Intensive Care and why it’s a shortcut to control, power and influence!”

    Controlling your emotions can be a challenge especially in difficult, unpredictable and unforeseeable situations like having a loved one critically ill in Intensive Care.

    You see, having a loved one critically ill in Intensive Care is not only a test to your emotional and mental well being, it’s also is a test for you and for your family to deal with your fears, frustrations, stress, vulnerability, overwhelm and struggle. Intensive Care is an unpredictable and volatile environment after all and by now you have probably discovered that the Intensive Care team is holding all the power, control and influence in this challenging situation.

    You need to take responsibility to control your emotions and I’ll show you how to

    Controlling your emotions quickly is therefore absolutely critical and if you have found that you have been struggling so far to manage and control your emotions since your loved has been admitted to Intensive Care for critical illness then you should continue reading, because I’ll explain to you why it’s so important that you take responsibility in controlling your emotions and also how you can control and manage your emotions in this unique, challenging and often “once in a lifetime” experience.

    You see, from my experience after more than 15 years Intensive Care Nursing in three different countries, I have seen and learned that 99% of Families of critically ill Patients in Intensive Care simply accept that losing your emotions, having your emotions overwhelm and control you and having the drama play havoc with your emotions is just the way it is. They also often think there is no better way…

    Because they see and learn this irrational and unhealthy behaviour from other Family’s of critically ill Patients in Intensive Care. They see and feel that Families of critically ill Patients don’t cope very well and they consciously or unconsciously imitate this unhealthy and irrational behaviour. Not good…

    Whilst in some instances the drama unfolds in front of their very eyes they get deeper and deeper into the emotional struggle…

    Families of critically ill Patients in Intensive Care are often so overwhelmed by the experience of having a loved one critically ill in Intensive Care that they don’t know what to do, they don’t know left from right and they therefore don’t seek out for help!

    In the meantime the Intensive Care team has taken over control, power and influence and whilst you and your family are busy struggling with your emotions that you can’t get a handle on, the Intensive Care team is busy pulling all the strings without your and your Family’s input…

    These are the situations where it’s extremely important that you have a handle on your emotions!

    Managing and controlling your emotions is especially important in situations where your critically ill loved one is either

    • Very unstable and in a very critical condition
    • Is in a life threatening situation
    • Is dying

    They also tend to be the situations where Families of critically ill Patients are having their emotions run havoc…

    But especially in those extremely challenging, difficult and volatile situations you need to have as much control, power and influence as possible, because if you don’t have control, power and influence and if you are still overwhelmed and controlled by your emotions, the Intensive Care team in the meantime has mapped out the game plan and has called the shots for you and for your critically ill loved one. And that game plan is most of the time driven by the things that are happening “behind the scenes” in Intensive Care and not by the clinical facts and realities. In fact it’s very rarely driven by the clinical facts and realities…

    If you don’t learn quickly how to manage and control your emotions the Intensive Care team will call the shots without you…

    You also need to know that the Intensive Care team knows and expects Families of critically ill Patients to be unable to manage their emotions and that’s exactly why the Intensive Care team has all the power, control and influence and that’s also why it’s so easy for the Intensive Care team to have the “behind the scenes” stuff dictate their positioning that often doesn’t reflect the clinical realities such as the diagnosis and prognosis of your critically ill loved one.

    What do I mean by that and how is it playing out in reality?

    You see, a lot of the things that happen in Intensive Care are intangible for you and your Family, because the wheels that are in motion are invisible for you and for your Family and the Intensive Care team makes sure that you don’t see any of it.

    Imagine that if your critically ill loved one is in any of the situations that I mentioned before, if they are either

    • Very unstable and in a very critical condition
    • Is in a life threatening situation
    • Is dying

    That’s pretty serious stuff and imagine you don’t know anything about the things that are happening “behind the scenes” and if you are unable to manage your emotions on top of that, it’s pretty bad news if you ask me… because the train will leave without you on board, so to speak and the Intensive Care team will have all the control, power and influence.

    When a situation in Intensive Care is as bad as any of the situations that I mentioned above, the Intensive Care team can be very quick in painting a “doom and gloom” picture, telling you and your Family that a “withdrawal of treatment” or a “limitation of treatment” might be “in the best interest” of your critically ill loved one.

    Here’s what’s going on “behind the scenes” that you are unaware of…

    What you don’t know is that the Intensive Care team is expecting five other admissions in the next 12 hours that are all competing for beds. What you also don’t know is that the Intensive Care team doesn’t have a strong interest in continuing treatment on your critically ill loved one because of the Intensive Care team having a bigger interest in

    • Treating other Patients that are seen as financially viable
    • Treating other Patients that may be enrolled in research studies and those research studies contribute to often 6, 7 or even 8- figure funding- so if your critically ill loved one doesn’t fall into a research category, the Intensive Care team may suggest to you and your Family that a “withdrawal or a limitation of treatment” might be in the “best interest” of your critically ill loved one, whereas in reality it’s “in the best interest” of the Intensive Care team
    • Not treating your critically ill loved one, because the ICU may have a staffing crisis. Intensive Care staff, whether doctors or nurses are generally speaking in high demand and again they may be needed to treat other Patients that the Intensive Care team has a higher interest in treating!

    Therefore you need to start taking control of your emotions quickly in order to have control, power and influence whilst your loved one is critically ill in Intensive Care, because you don’t want to have the Intensive Care team driving their agenda without you knowing and understanding what’s really happening…

    So how do you do that? How can you take control of your emotions quickly, whilst your loved one is critically ill in Intensive Care?

    I’m glad you’ve asked…

    So let’s look at how you and your Family can manage your emotions quickly whilst your loved one is critically ill in Intensive Care

    1.       Take a step back and look at the situation from a “bird’s eye view”

    Look, I understand that you are fully immersed in this difficult and challenging situation, however whilst you are caring and loving towards your critically ill loved one, your emotions have taken over your rational thinking and your rational brain. Therefore take a step back immediately and temporarily, remove your emotions from the situation for a minute and look at the situation from a “bird’s eye view”. What would a bird see flying above the Intensive Care Unit looking at your and your critically ill loved one’s situation? The bird would most likely see a distressed Family, controlled by their emotions, who can’t see what’s really happening and who can’t get a grip and a handle on the situation.

    Therefore push your emotions aside temporarily NOW, get a grip on things and start asking the right questions. Do that and you will find that you will be moving in the right direction.

    Don’t get me wrong here, your emotions as they relate to your critically ill loved one’s well being are a healthy sign and it shows you are loving, determined and committed to the cause, however you can’t allow your emotions run havoc and therefore have the Intensive Care team running the show…

    2.       Start managing the situation proactively and don’t be a passive bystander

    You see 99% of Families of critically ill Patients in Intensive Care are overwhelmed and controlled by their emotions.

    They are therefore passive bystanders of the situation and the Intensive Care team knows and expects that.

    You need to start asking the right questions and assume control, power and influence. Once you have done that you will see the dynamics shift immediately.

    You will find that the Intensive Care team is looking at you and your Family differently. But it’s not going to happen without you putting your emotions aside, look reality in the eye, assume control, power and influence, ask the right questions and ask for what you want, irrespective of what the Intensive Care team is telling you.

    The reality is that if you don’t ask for what you want, you will never find out the real situation that your critically ill loved one is in, because after you have asked for what you want you will see how the Intensive Care team reacts. And most of the time the Intensive Care team is taken aback by Family’s asking for what they want. But you need to exactly do that and you need to be brave and bold!

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     

    Related Articles:

    How to control your emotions QUICKLY whilst your loved one is critically ill in Intensive Care and why it’s a SHORTCUT to control, power and influence! is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/control-emotions-quickly-whilst-loved-one-critically-ill-intensive-care-shortcut-control-power-influence/feed/ 0 http://youtu.be/wctbEne53Qc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+control+your+emotions+quickly+whilst+your+loved+one+is+critically+ill+in+Intensive+Care!.mp3 - Hi, http://youtu.be/wctbEne53Qc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+control+your+emotions+quickly+whilst+your+loved+one+is+critically+ill+in+Intensive+Care!.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAR... intensiv yes
    How LONG does it take to come off a ventilator/ respirator in Intensive Care? http://intensivecarehotline.com/long-take-come-ventilator-respirator-intensive-care/ http://intensivecarehotline.com/long-take-come-ventilator-respirator-intensive-care/#comments Sun, 09 Mar 2014 20:00:51 +0000 http://intensivecarehotline.com/?p=5335 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+does+it+take+to+come+off+a+ventilator+in+Intensive+Care-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    How LONG does it take to come off a ventilator/ respirator in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered another question from one of our dear readers and the question last week was, “My mother wants to go home on a BIPAP machine from Intensive Care, can she survive?, you can check it out here.

    In this week’s episode of your questions answered I want to answer another one of our most frequently asked questions and the question this week is “How long does it take to come off a ventilator/ respirator in Intensive Care?”

    Now, if your loved one has just been admitted to Intensive Care for critical illness, chances are that you and your Family feel challenged, out of your comfort zone, fearful, frightened, vulnerable, stressed and you feel like you are overwhelmed. Furthermore, you feel like other people are running the show and you feel like you have no or very little power, control and influence over this challenging situation.

    You are also looking for answers and some of your questions may have already been answered by the Intensive Care team, however you may have also felt like not all your questions are welcome, as the Intensive Care team often also speaks in medical terms and in their medical jargon that is difficult to understand.

    Your critically ill loved one is probably ventilated with a breathing tube(endotracheal tube) in their throat and in an induced coma.

    You are probably shocked by how your critically ill loved one looks with the ventilator / respirator and the breathing tube attached to them. You probably also feel intimidated by the Intensive Care team and by all the equipment and the technology in Intensive Care…

    Nevertheless, you and your Family are wondering how long it will take for your critically ill loved one to recover and you are also wondering how long it will take for your critically ill loved one to come off the ventilator?

    Ok, in order to give you an answer to this question, we have to break it down in some segments, because the length of a time on a ventilator is dependent on a number of things that I will explain here:

     I’ll give you some quick examples so that you understand

    1.       “Straight forward” and “soft” admissions to Intensive Care

    If your critically ill loved one is a “straight forward” admission to Intensive Care after elective or planned surgery or is a “soft” admission to Intensive Care for a medical emergency on a ward etc… your critically ill loved one should come off the ventilator/ respirator and out of the induced coma relatively quickly within 12- 72 hours!

    Ventilation and a breathing tube after surgery are sometimes stabilising and prophylactic measures and are also measures to make sure that your loved one isn’t bleeding before the Intensive Care team takes them off the ventilator/ respirator, which is especially important after surgery. The same applies to other “soft” admissions into Intensive Care after your loved one may have had some breathing issues and they may have required the ventilator/ respirator and breathing tube for a little while to improve your loved one’s lungs with some extra pressure and oxygen. No big deal, the induced coma, the tube and the ventilator should be gone soon.

    2.       Ventilated for 3- 7 days

    If your critically ill loved one is a more complicated admission to Intensive Care and is more unstable, such as after a car accident or after major surgery where complications occurred or if your critically ill loved one sustained a head or brain injury or had a heart attack or cardiac arrest, then the breathing tube, the ventilator/ respirator and the induced coma might be required for more than 72 hours and if your loved one is stable and progressing, breathing up on the ventilator/ respirator with the support from the ventilator/ respirator being reduced then again, your critically ill loved one should be able to come off the ventilator/ respirator.

    Again, coming off the ventilator/ respirator after more than 72 hours of ventilation and induced coma, might be a little bit more difficult, because as a rule of thumb, the longer ventilation is required, the higher the risk that complications and/or delays occur of course.

    So, once again, if your critically ill loved one is stable and has shown strength to breath by themselves there should be no reason that they can’t be taken off the ventilator after 3-7 days, generally speaking.

    3.       Ventilated for more than 7 days

    If your critically ill loved one has been in Intensive Care for more than one week now and has been ventilated for more than one week by now and is still in the induced coma, you’re probably wondering and you are more importantly worried when your loved one will finally come off the ventilator.

    Now, if after one week of ventilation and an induced coma the Intensive Care team still doesn’t feel confident to take out the breathing tube, they may suggest to insert a Tracheostomy.  Before they actually suggest a Tracheostomy they should try and get your loved one out of the induced coma first and if your loved one is “waking up” and is cooperative and can breathe, the Intensive Care team should remove the breathing tube and give your critically ill loved one “a fair go” first to find out whether your loved one can breathe without a breathing tube and without the ventilator/ respirator.

    If that fails, then the Intensive Care team would have a fair point to suggest a Tracheostomy, but once again that shouldn’t be brought up before or after at least 7-10 days of ventilation. And again it shouldn’t be done until the Intensive Care team is certain that there is no other alternative.

    Once your loved one has a Tracheostomy we should be looking at the next example number 4.

    4.       Having a Tracheostomy

    Your critically ill loved one is having a Tracheostomy because they went through one or multiple failed extubations (removal of the breathing tube in the mouth) and they were unable to breathe without the ventilator/ respirator support. Furthermore, your critically ill loved one may also be required to stay in Intensive Care for a prolonged period of time with ventilator support due to their critical illness.

    The advantage your critically ill loved one is having now is that they should be able to be brought out of the induced coma and they should be able to “wake up” and hopefully communicate, at least non-verbally, because a Tracheostomy doesn’t give your loved one the ability to talk.

    Keep in mind that with ventilation through the breathing tube in the mouth, an induced coma would have been necessary, whereas a Tracheostomy can usually be tolerated without the induced coma.

    A Tracheostomy generally speaking also brings the advantage of getting your critically ill loved one off the ventilator quicker by trying to breathe without the ventilator/ respirator just via an oxygen mask via the Tracheostomy. The goal here is to increase the frequency your loved one can stay off the ventilator/ respirator. Initially this might be two hours on the ventilator and two hours off the ventilator. As soon as your loved one can stay off the ventilator for >24 hours, they should, in most instances, be able to leave Intensive Care, even with a Tracheostomy still in place. However many Patients also can have their Tracheostomy removed in Intensive Care before going to the ward.

    How long does it take to wean ventilation and the Tracheostomy? It depends. It can range from a few days to a few weeks and sometimes few months.

    If you are finding that your critically ill loved one is stuck on a ventilator with Tracheostomy and is not moving forward you have a few alternatives and options to consider:

    A)Read this article here

    Tracheostomy and weaning off the ventilator in Intensive Care, how long can it take?” (Click on the link)

    B) look for alternatives such as Intensive Home Care services that provide a genuine alternative to a long-term stay in Intensive Care for long-term ventilated Adults& Children with Tracheostomy. Find more information here www.INTENSIVECAREATHOME.COM.AU (Click on the link)

    C) Put pressure on the Intensive Care team and demand more! How do you do that?

    I’m glad you’ve asked!

    How can You  leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     

    Related Articles

     

    How LONG does it take to come off a ventilator/ respirator in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

    The post How LONG does it take to come off a ventilator/ respirator in Intensive Care? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/long-take-come-ventilator-respirator-intensive-care/feed/ 0 http://youtu.be/vfCa1NX27DE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+does+it+take+to+come+off+a+ventilator+in+Intensive+Care-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/vfCa1NX27DE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+does+it+take+to+come+off+a+ventilator+in+Intensive+Care-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered another question from one of our dear readers and the question last week was, “My mother wants to go home on a BIPAP machine from Intensive Care, can she survive?” (http://intensivecarehotline.com/mother-wants-go-home-bipap-machine-intensive-care-can-survive/), you can check it out here. In this week’s episode of “your questions answered” I want to answer another one of our most frequently asked questions and the question this week is “How long does it take to come off a ventilator/ respirator in Intensive Care?” Now, if your loved one has just been admitted to Intensive Care for critical illness, chances are that you and your Family feel challenged, out of your comfort zone, fearful, frightened, vulnerable, stressed and you feel like you are overwhelmed. Furthermore, you feel like other people are running the show and you feel like you have no or very little power, control and influence over this challenging situation. You are also looking for answers and some of your questions may have already been answered by the Intensive Care team, however you may have also felt like not all your questions are welcome, as the Intensive Care team often also speaks in medical terms and in their medical jargon that is difficult to understand. Your critically ill loved one is probably ventilated with a breathing tube(endotracheal tube) in their throat and in an induced coma. You are probably shocked by how your critically ill loved one looks with the ventilator / respirator and the breathing tube attached to them. You probably also feel intimidated by the Intensive Care team and by all the equipment and the technology in Intensive Care… Nevertheless, you and your Family are wondering how long it will take for your critically ill loved one to recover and you are also wondering how long it will take for your critically ill loved one to come off the ventilator? Ok, in order to give you an answer to this question, we have to break it down in some segments, because the length of a time on a ventilator is dependent on a number of things that I will explain here:  I’ll give you some quick examples so that you understand 1.       “Straight forward” and “soft” admissions to Intensive Care If your critically ill loved one is a “straight forward” admission to Intensive Care after elective or planned surgery or is a “soft” admission to Intensive Care for a medical emergency on a ward etc… your critically ill loved one should come off the ventilator/ respirator and out of the induced coma relatively quickly within 12- 72 hours! Ventilation and a breathing tube after surgery are sometimes stabilising and prophylactic measures and are also measures to make sure that your loved one isn’t bleeding before the Intensive Care team takes them off the ventilator/ respirator, which is especially important after surgery. The same applies to other “soft” admissions into Intensive Care after your loved one may have had some breathing issues and they may have required the ventilator/ respirator and breathing tube for a little while to improve your loved one’s lungs with some extra pressure and oxygen. No big deal, the induced coma, the tube and the ventilator should be gone soon. 2.       Ventilated for 3- 7 days If your critically ill loved one is a more complicated admission to Intensive Care and is more unstable, intensiv yes
    My mother wants to go home on a BIPAP machine from Intensive Care, can she survive? http://intensivecarehotline.com/mother-wants-go-home-bipap-machine-intensive-care-can-survive/ http://intensivecarehotline.com/mother-wants-go-home-bipap-machine-intensive-care-can-survive/#comments Mon, 03 Mar 2014 20:00:33 +0000 http://intensivecarehotline.com/?p=5268 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+mother+wants+to+go+home+on+a+BIPAP+machine+from+Intensive+Care%2C+can+she+survive-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    My mother wants to go home on a BIPAP machine from Intensive Care, can she survive? is a post from: INTENSIVE CARE HOTLINE

    The post My mother wants to go home on a BIPAP machine from Intensive Care, can she survive? appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I wrote about How long is too long to stay on a ventilator or respirator?” Check it out here.

    In this week’s episode of your questions answered, one of our dear readers from Perth, Australia asks the following question: “My mother wants to go home on a BIPAP machine from Intensive Care, can she survive?”

    Dear Patrik,

    This is Louise from Perth, Australia

    I need your feedback and help regarding this and I hope to receive your answer as soon as possible.

    My mother aged 75 yrs has been admitted to the ICU because of respiratory failure. It’s been a week that she has been there with the help of the BiPAP machine. She is completely dependent on the BIPAP machine. But she is conscious and is recognising people well enough, but she’s struggling to cope with the situation and I’m not sure whether she’ll survive. She is suffering from long standing diabetes and hypertension too.

    It’s been just a few hours that our family decided to get her discharged from the hospital and provide the entire equipment at home ourself. We are sick of the hospital system and we want her at home with dignity and privacy. She has now been treated from home by our family with the entire life supporting system.

    The doctors have also diagnosed changes in the renal system too.

    I would like to know that for how long can my mother survive on that machine in this condition. I hope to receive your reply at your earliest convenience.

    Regards

    Louise

     Dear Louise,

    thank you for your email and thank you for your question!

    I’m sorry to hear what you are going through with your mother, however I can see some good things coming out of the situation as well.

    I can also only commend you for taking your mother home to provide her with privacy and dignity something that can often not be achieved in Intensive Care!

    To answer your questions, if your mother is in respiratory failure and BIPAP dependent and wants to go home, you may have to think about the following questions and I’m sure that you, your family and your mother may have already thought about some of those questions.

    • Is your mother going  home and expects to improve her situation?
    • Is your mother going home, because she doesn’t want to stay in Intensive Care and she wants comfort at home?
    • If the latter is the case, I can only commend you for your decision, because a lot is possible at home and just by taking your mother out of Intensive Care to the comfort of her own home she will probably get a moral boost, even though she may be sick and weak at the moment.

    To put things in perspective for you and for your family, the reality is that some people live at home, fully ventilated and fully ventilator dependent with Tracheostomy. They generally do so with the help of specialized Intensive Home Care nursing services such as INTENSIVE CARE AT HOME (www.intensivecareathome.com.au) in Australia. Other countries such as Germany, Austria and Switzerland also have a longstanding history of Intensive Home Care services for ventilator dependent Adults& Children with Tracheostomy as a genuine alternative to Intensive Care.

    You didn’t mention a Tracheostomy, so I assume that your grandmother is on a BIPAP machine ventilator dependent with a face mask. Generally speaking and in theory, people can “live” on a BIPAP machine indefinitely, however with the other medical issues that you’ve mentioned such as the respiratory failure, the hypertension, diabetes and the kidney issues you and your family might need professional help in order to prolong the life of your mother if that’s what you want.

    For more information about how long people can live on a BIPAP machine check out this article here(click on the link)  “How long is a Patient kept on a BIPAP machine in Intensive Care?

     In an Intensive Care environment, your mother would have close monitoring of her hypertension, of her diabetes and her kidney issues. In order for your mother to improve at home, the same would apply. Having said that as I have hinted before, I am personally a big believer in home care and there is no reason why your mother can’t have those observations at home as well.

    My biggest concern with home BIPAP and kidney issues or kidney failure is that if the kidneys don’t work properly, your mother might get fluid overloaded as the diminished Urine output might accumulate fluids in the lungs and make your mother even more dependent on the BIPAP. Therefore, depending on the severity of the kidney issues you might have to keep a close eye on fluid intake and urine output, in order to not have your mother fluid overloaded.

    The biggest question however for you, for your Family and for your mother is what do you want to achieve? Are you seeking comfort measures in your own home or are you seeking to improve your mother’s situation and have her off the ventilator completely?

    If you could shed more light on your situation, I can certainly point you in the right direction. Part of our services here in Australia is to provide INTENSIVE CARE AT HOME (www.intensivecareathome.com.au) services, so I can give you expert advice if you can be more specific about your situation.

    Thank you& Kind Regards

    Sincerely, your friend

    Patrik Hutzel

    How can You leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    My mother wants to go home on a BIPAP machine from Intensive Care, can she survive? is a post from: INTENSIVE CARE HOTLINE

    The post My mother wants to go home on a BIPAP machine from Intensive Care, can she survive? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/mother-wants-go-home-bipap-machine-intensive-care-can-survive/feed/ 0 http://youtu.be/wN-As3EF--4 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+mother+wants+to+go+home+on+a+BIPAP+machine+from+Intensive+Care%2C+can+she+survive-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/wN-As3EF--4 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+mother+wants+to+go+home+on+a+BIPAP+machine+from+Intensive+Care%2C+can+she+survive-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I wrote about “How long is too long to stay on a ventilator or respirator?” Check it out here. In this week’s episode of “your questions answered”, one of our dear readers from Perth, Australia asks the following question: “My mother wants to go home on a BIPAP machine from Intensive Care, can she survive?” Dear Patrik, This is Louise from Perth, Australia I need your feedback and help regarding this and I hope to receive your answer as soon as possible. My mother aged 75 yrs has been admitted to the ICU because of respiratory failure. It’s been a week that she has been there with the help of the BiPAP machine. She is completely dependent on the BIPAP machine. But she is conscious and is recognising people well enough, but she’s struggling to cope with the situation and I’m not sure whether she’ll survive. She is suffering from long standing diabetes and hypertension too. It’s been just a few hours that our family decided to get her discharged from the hospital and provide the entire equipment at home ourself. We are sick of the hospital system and we want her at home with dignity and privacy. She has now been treated from home by our family with the entire life supporting system. The doctors have also diagnosed changes in the renal system too. I would like to know that for how long can my mother survive on that machine in this condition. I hope to receive your reply at your earliest convenience. Regards Louise  Dear Louise, thank you for your email and thank you for your question! I'm sorry to hear what you are going through with your mother, however I can see some good things coming out of the situation as well. I can also only commend you for taking your mother home to provide her with privacy and dignity something that can often not be achieved in Intensive Care! To answer your questions, if your mother is in respiratory failure and BIPAP (http://intensivecarehotline.com/bipap/)dependent and wants to go home, you may have to think about the following questions and I'm sure that you, your family and your mother may have already thought about some of those questions. * Is your mother going  home and expects to improve her situation? * Is your mother going home, because she doesn't want to stay in Intensive Care and she wants comfort at home? * If the latter is the case, I can only commend you for your decision, because a lot is possible at home and just by taking your mother out of Intensive Care to the comfort of her own home she will probably get a moral boost, even though she may be sick and weak at the moment. To put things in perspective for you and for your family, the reality is that some people live at home, fully ventilated and fully ventilator dependent with Tracheostomy. They generally do so with the help of specialized Intensive Home Care nursing services such as INTENSIVE CARE AT HOME (http://intensivecareathome.com.au) (www.intensivecareathome.com.au (http://www.intensivecareathome.com.au/)) in Australia. Other countries such as Germany, Austria and Switzerland also have a longstanding history of Intensive Home Care services for ventilator dependent Adults& Children with Tracheostomy as a genuine alternative to Intensive Care. You didn't mention a Tracheostomy (http://intensivecarehotline.com/tracheostomy/), intensiv yes
    Podcast interview with Delia Scales, founder of Wikihospitals http://intensivecarehotline.com/podcast-interview-delia-scales-founder-wikihospitals/ http://intensivecarehotline.com/podcast-interview-delia-scales-founder-wikihospitals/#comments Sun, 02 Mar 2014 21:50:46 +0000 http://intensivecarehotline.com/?p=5264 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.podcast/Delia+Interview.mp3 In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Delia Scales founder of WIKIHOSPITALS.COM.AU Wikihospitals.com.au is an Australian website, inspired by both Wikileaks and Wikipedia. It stands for open exposure of major healthcare problems and free, high quality, on-line disease and treatment information. In this episode of the INTENSIVECAREHOTLINE.COM podcast you’ll discover the health industry is not like […]

    Podcast interview with Delia Scales, founder of Wikihospitals is a post from: INTENSIVE CARE HOTLINE

    The post Podcast interview with Delia Scales, founder of Wikihospitals appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.podcast/Delia+Interview.mp3

    In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Delia Scales founder of WIKIHOSPITALS.COM.AU

    Wikihospitals.com.au is an Australian website, inspired by both Wikileaks and Wikipedia. It stands for open exposure of major healthcare problems and free, high quality, on-line disease and treatment information.

    In this episode of the INTENSIVECAREHOTLINE.COM podcast you’ll discover

    • the health industry is not like any other industry and is often a 19th century antiquated style system
    • why there is a lot of secrecy around health care
    • Delia shot some videos about a Patient who nearly lost her leg due to private hospital negligence
    • Why the only time clinical incidents may be publicly exposed is if there is a coroner’s case after a Patient’s death
    • Why some Patients are made NFR(Not for resuscitation) without Patient and Family consent and why it’s a disgrace
    • Why there is a big fight and massive competition for Intensive Care beds and how Hospitals try to manage it
    • How Patrik’s service INTENSIVE CARE AT HOME can help free up expensive and precious Intensive Care beds and why it creates a win-win situation for Patients, Families and Intensive Care Units
    • Why the health industry in Australia is not competitive compared to other first world countries and why it needs changing to improve the system and Patient outcomes
    • Find out Delia’s vision and dreams what WIKIHOSPITALS will do for Patients and their Families
    • Why “gag orders” for doctors put another “lid on the pot“ to public exposure of clinical incidents and negligence in hospitals
    • Why Delia thinks that accreditation processes of Hospitals are flawed and what WIKIHOSPITALS can do in order to bring transparency for Patients and their Families
    • Delia wants a big and bold public exposure of what’s going on “behind the scenes” in hospitals
    • Why current clinical practice and paradigms are often research driven and therefore fail to provide care to some Patients who don’t fall into a research category
    • Why the Internet will be changing the health industry with freely and publicly available information that was previously hidden
    • Why big public and private Hospitals don’t have a blog and why it’s an obstacle to transparency

    Podcast interview with Delia Scales, founder of Wikihospitals is a post from: INTENSIVE CARE HOTLINE

    The post Podcast interview with Delia Scales, founder of Wikihospitals appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/podcast-interview-delia-scales-founder-wikihospitals/feed/ 0 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.podcast/Delia+Interview.mp3 - In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Delia Scales founder of WIKIHOSPITALS.COM.AU - Wikihospitals.com. https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.podcast/Delia+Interview.mp3 In this episode of the INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com/) Podcast I interviewed Delia Scales founder of WIKIHOSPITALS.COM.AU (http://wikihospitals.com.au) Wikihospitals.com.au is an Australian website, inspired by both Wikileaks and Wikipedia. It stands for open exposure of major healthcare problems and free, high quality, on-line disease and treatment information. In this episode of the INTENSIVECAREHOTLINE.COM podcast you’ll discover * the health industry is not like any other industry and is often a 19th century antiquated style system * why there is a lot of secrecy around health care * Delia shot some videos about a Patient who nearly lost her leg due to private hospital negligence * Why the only time clinical incidents may be publicly exposed is if there is a coroner’s case after a Patient’s death * Why some Patients are made NFR(Not for resuscitation) without Patient and Family consent and why it’s a disgrace * Why there is a big fight and massive competition for Intensive Care beds and how Hospitals try to manage it * How Patrik’s service INTENSIVE CARE AT HOME can help free up expensive and precious Intensive Care beds and why it creates a win-win situation for Patients, Families and Intensive Care Units * Why the health industry in Australia is not competitive compared to other first world countries and why it needs changing to improve the system and Patient outcomes * Find out Delia’s vision and dreams what WIKIHOSPITALS will do for Patients and their Families * Why “gag orders” for doctors put another “lid on the pot“ to public exposure of clinical incidents and negligence in hospitals * Why Delia thinks that accreditation processes of Hospitals are flawed and what WIKIHOSPITALS (http://wikihospitals.com.au) can do in order to bring transparency for Patients and their Families * Delia wants a big and bold public exposure of what’s going on “behind the scenes” in hospitals * Why current clinical practice and paradigms are often research driven and therefore fail to provide care to some Patients who don’t fall into a research category * Why the Internet will be changing the health industry with freely and publicly available information that was previously hidden * Why big public and private Hospitals don’t have a blog and why it’s an obstacle to transparency intensiv yes
    How long is too long to stay on a ventilator or respirator? http://intensivecarehotline.com/long-long-stay-ventilator-respirator/ http://intensivecarehotline.com/long-long-stay-ventilator-respirator/#comments Mon, 24 Feb 2014 20:00:47 +0000 http://intensivecarehotline.com/?p=5229 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+long+is+too+long+on+a+ventilator+or+respirator-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    How long is too long to stay on a ventilator or respirator? is a post from: INTENSIVE CARE HOTLINE

    The post How long is too long to stay on a ventilator or respirator? appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered another one of our reader’s questions and the questions was

    My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused“ Check it out here.

    In this week’s episode of your questions answered I want to answer a question that we get very frequently and therefore I want to answer this question in this week’s your questions answered section.

    The question that our readers ask is “How long is too long to stay on a ventilator or respirator?”

     Now, if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation on a ventilator/ respirator with a breathing tube(endotracheal tube) and is also in an induced coma, chances are that you and your Family feel challenged, vulnerable, frustrated, out of your comfort zone, out of control, powerless and without influence!

    You and your Family also have millions of questions running through your mind and especially with the Intensive Care team being busy and also with the Intensive Care team often not having the willingness to speak your language and to answer ALL of your questions whilst your loved one is critically ill in Intensive Care you may still wonder “How long is too long to stay on a ventilator or respirator for your critically ill loved one?”

     Facts& Figures

    Lets quickly look at the facts& figures in Intensive Care. According to most statistics and research that has been published, around 40- 60% out of all admissions to Intensive Care require mechanical and invasive ventilation during their stay in Intensive Care. That’s about half out of all admissions to Intensive Care.

    Now, the reality is that if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation with a breathing tube and is in an induced coma- it all depends.

    It all depends and it’s very often not “straight forward” or linear

    In theory any critically ill Patient in Intensive Care can stay on a ventilator almost indefinitely if they are stable. However I need to break this “indefinite stay” on a ventilator down for you so that you understand the stages.

    There are a few scenarios in Intensive Care that generally happen when a critically ill Patient is on a ventilator with a breathing tube and an induced coma. Let’s look at them in detail. You will also find links to other related articles that educate you and your Family about ventilation, induced coma and Tracheostomy in Intensive Care. Just click on the links below the article to find out more!

    1)      Straight forward “bed& breakfast(b&b)” admission

    Your critically ill loved one is a “straight forward” or “soft” admission and only requires the ventilator post surgery and for a few hours up to one day or two. Your loved one won’t need the ventilator/ respirator and breathing tube for very long, will be extubated(taken off the ventilator) and will be out of Intensive Care soon if otherwise stable. Many Intensive Care Units also refer to those Patients as “bed and breakfast” Patients!

    2)      Not quite “straight forward” but the end of requiring ventilation and the induced coma is in sight

    Your critically ill loved one is requiring the ventilator/ respirator, the breathing tube and the induced coma for a few days for a more complex admission such as Pneumonia, Stroke, Sepsis, Head injury, Multi- Trauma, Abdominal Aneurysm Repair etc… You will find a list of most admission scenarios requiring ventilation here.

    This situation often means that your critically ill loved one is not a “straight forward” admission however the Intensive Care team has still told you that your critically ill loved one can be taken off the ventilator and “woken up” out of the induced coma within 3-7 days, as a rule of thumb! “Waking up” and getting out of the induced coma can sometimes be challenging and is often not linear or “straight forward”, however chances in this situation to get your loved one off the ventilator within a few days are good! Once off the ventilator your loved one should be able to leave Intensive Care within a few days!

    3)      A Tracheostomy to wean your loved one off the ventilator is required and the weaning off the ventilator can be achieved within a few days or weeks

    Your critically ill loved one requires ventilation for more than 7 days and is still not progressing and the Intensive Care team has hinted that your critically ill loved one will have difficulties to be weaned off the ventilator and therefore the Intensive Care team is thinking about a Tracheostomy insertion. The reason for a Tracheostomy insertion is often that weaning off the ventilator/ respirator can be achieved easier with a Tracheostomy, because your critically ill loved one can be removed from the induced coma that is often a requirement to tolerate a breathing tube. That is often not the case with a Tracheostomy. After a Tracheostomy has been inserted, your critically ill loved one may be removed from the induced coma and can get more alert and might even be able to communicate. A Tracheostomy is just so much easier to tolerate compared to a breathing tube. Furthermore, it is then easier to gradually wean your critically ill loved one off the ventilator/ respirator once the sedation and pain medication has been reduced. Also, your critically ill loved one is then in a situation to be taken off the ventilator for a few hours a day as a starting point and it’s easy to take your loved one off the ventilator and back on again. That gives the Intensive Care team the option to properly assess how your critically ill loved one is progressing towards weaning off the ventilator/ respirator. Once the ventilator/ respirator has been weaned and your critically ill loved one can breathe independently via the Tracheostomy, has a good cough and can swallow, then the removal of the Tracheostomy is the next step. This process can take a few days to a few weeks, depending on your critically ill loved one’s overall situation.

    4)      Your critically ill loved one is a “slow and difficult respiratory wean” and there is no end in sight

    Your critically ill loved one has had the Tracheostomy inserted and has come out of the induced coma and has been in Intensive Care for more than two weeks. Sometimes critically ill Patients in Intensive Care who are ventilator dependent and who have a Tracheostomy might be referred to as a “slow respiratory wean” or in other words, your critically ill loved one is ventilator dependent in Intensive Care with a Tracheostomy and there is no end on sight. It’s one of the biggest challenges in Intensive Care and the longer your critically ill loved one is in Intensive Care requiring mechanical ventilation and the Tracheostomy, the challenges such as depression, lack of Quality of life, the risk to acquire an infection in Intensive Care, the lack of natural daylight, the lack of fresh air, a disturbed day and night rhythm, the lack of privacy and dignity and the total lack of control, power and influence are massive challenges for all parties involved. This situation is an extremely difficult situation and thankfully at least in some parts of the world a solution for those Patients to get them out of Intensive Care quicker and in a home care environment exists. For example if you happen to live in Australia INTENSIVE CARE AT HOME (www.INTENSIVECAREATHOME.COM.AU ) is offering a genuine alternative to a long term stay in Intensive Care in a home care environment. Check out their website here www.INTENSIVECAREATHOME.COM.AU

    If you don’t happen to live in Australia, your biggest challenge is to have control, power and influence in this situation, because the power dynamics in Intensive Care are often one sided and not equal, with the Intensive Care team having all the perceived power and perceived decision making authority if you don’t challenge it and if you don’t know what’s happening “behind the scenes” in Intensive Care.

    Especially in countries where Intensive Home Care services don’t exist the Intensive Care team might suggest to you and your Family that a “withdrawal of treatment” or a “limitation of treatment” might be “in the best interest” of your critically ill loved one.

    Your challenge is to look “behind the scenes” and understand what the Intensive Care team’s interests really are such as research activities, bed scarcity, staffing crisis and the perceived non- financial viability of your critically ill loved one’s (long-term) stay in Intensive Care that could all well impact on how the Intensive Care team positions your critically ill loved one’s prognosis and diagnosis.

    The bottom line here is that you need to educate yourself quickly and succinctly in order to have control, power and influence, because the Intensive Care team is so used and adept to be “running the show” and have all the power, control and influence whilst your loved one is critically ill in Intensive Care. Your job is to educate yourself quickly how you can have control, power and influence. How can you do that?

    I’m glad you’ve asked!

    You can leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    How long is too long to stay on a ventilator or respirator? is a post from: INTENSIVE CARE HOTLINE

    The post How long is too long to stay on a ventilator or respirator? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/long-long-stay-ventilator-respirator/feed/ 0 http://youtu.be/06uRpjc-TSA https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+long+is+too+long+on+a+ventilator+or+respirator-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/06uRpjc-TSA https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+long+is+too+long+on+a+ventilator+or+respirator-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered another one of our reader's questions and the questions was "My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused (http://intensivecarehotline.com/husband-severe-pneumoniawas-ventilatedheavily-sedated-icu-now-hes-confused/)" Check it out here. In this week’s episode of “your questions answered” I want to answer a question that we get very frequently and therefore I want to answer this question in this week’s “your questions answered” section. The question that our readers ask is “How long is too long to stay on a ventilator or respirator?”  Now, if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation on a ventilator/ respirator with a breathing tube(endotracheal tube) and is also in an induced coma, chances are that you and your Family feel challenged, vulnerable, frustrated, out of your comfort zone, out of control, powerless and without influence! You and your Family also have millions of questions running through your mind and especially with the Intensive Care team being busy and also with the Intensive Care team often not having the willingness to speak your language and to answer ALL of your questions whilst your loved one is critically ill in Intensive Care you may still wonder “How long is too long to stay on a ventilator or respirator for your critically ill loved one?”  Facts& Figures Lets quickly look at the facts& figures in Intensive Care. According to most statistics and research that has been published, around 40- 60% out of all admissions to Intensive Care require mechanical and invasive ventilation during their stay in Intensive Care. That’s about half out of all admissions to Intensive Care. Now, the reality is that if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation with a breathing tube and is in an induced coma- it all depends. It all depends and it’s very often not “straight forward” or linear In theory any critically ill Patient in Intensive Care can stay on a ventilator almost indefinitely if they are stable. However I need to break this “indefinite stay” on a ventilator down for you so that you understand the stages. There are a few scenarios in Intensive Care that generally happen when a critically ill Patient is on a ventilator with a breathing tube and an induced coma. Let’s look at them in detail. You will also find links to other related articles that educate you and your Family about ventilation, induced coma and Tracheostomy in Intensive Care. Just click on the links below the article to find out more! 1)      Straight forward “bed& breakfast(b&b)” admission Your critically ill loved one is a “straight forward” or “soft” admission and only requires the ventilator post surgery and for a few hours up to one day or two. Your loved one won’t need the ventilator/ respirator and breathing tube for very long, will be extubated(taken off the ventilator) and will be out of Intensive Care soon if otherwise stable. Many Intensive Care Units also refer to those Patients as “bed and breakfast” Patients! 2)      Not quite “straight forward” but the end of requiring ventilation and the induced coma is in sight Your critically ill loved one is requiring the ventilator/ respirator, intensiv yes
    Is it “SEXY” for the Intensive Care team to treat your loved one who requires a long-term stay in Intensive Care? http://intensivecarehotline.com/sexy-intensive-care-team-treat-loved-one-requires-long-term-stay-intensive-care/ http://intensivecarehotline.com/sexy-intensive-care-team-treat-loved-one-requires-long-term-stay-intensive-care/#comments Sun, 23 Feb 2014 20:00:26 +0000 http://intensivecarehotline.com/?p=5225 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Is+it++sexy++for+the+ICU+team+to+treat+your+loved+one+who+requires+a+long-term+stay+in+ICU-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care” You can read, watch or listen to the update here.

    In this week’s blog I want to give you insight in how the Intensive Care team might view a long-term stay of your critically ill loved one in Intensive Care and it’s time that we ask “Is it “sexy” for the Intensive Care team to treat your loved one who requires a long-term stay in Intensive Care?”

    If your critically ill loved one has been admitted to Intensive Care for critical illness and furthermore, if your critically ill loved one requires a long-term stay in Intensive Care, chances are that you feel fearful, frightened, uneasy, challenged and very vulnerable.

    What is a long-term stay in Intensive Care?

    First of all, let’s just quickly look at the definition of a “long-term stay” in Intensive Care. A long term stay in Intensive Care is generally speaking any stay that goes beyond the 2-3 week mark and can last forever so to speak. The longest stay in Intensive Care that I have come across in more than 15 years Intensive Care nursing in three different countries is around 18 months. However I have heard of cases that stayed up to two years.

    Intensive Care is not a very pleasant environment at the best of times, let alone a long-term stay in Intensive Care.

    You will encounter unique challenges whilst your loved one is critically ill in Intensive Care

    And with a long-term stay in Intensive Care, generally speaking come unique challenges, whether it be for you, for your Family, for the Intensive Care team and most of all for your critically ill loved one.

    Your critically ill loved one who is, who has been or who will be in Intensive Care for long periods of time will most likely get depressed, due to the fact that the long-term stay in Intensive Care offers very little or no Quality of Life. Moreover, a long-term stay in Intensive Care also offers limited or no privacy and dignity. Furthermore, with the Intensive Care team holding all the perceived power and also holding the perceived decision making power and authority, the situation that you, your Family and your critically ill loved one find yourself in, is a situation where you feel like you have little or no control, power and influence.

    That is of course only, if you are like 99% of Families of critically ill Patients in Intensive Care who think and act as if they have no power, control and influence whilst their loved one is critically ill in Intensive Care and those 99% of Families also don’t question the status quo with the Intensive Care team holding most of the perceived power. That’s a big mistake!

    The 1% of Families who do have control, power and influence educate themselves and they also act like they have control, power and influence and it makes all the difference!

    And also, as a quick frame of reference, when I talk about a long-term Patient in Intensive Care, most of the time I refer to a long-term ventilated Patient with Tracheostomy. There are other examples that require a long term stay in Intensive Care such as ECMO, Haematology or Leukaemia Patients, however the majority of long-term Patients in Intensive Care generally speaking require some form of mechanical ventilation with Tracheostomy.

    Are you and your Family close to a nervous breakdown because you are spending far too much time in Intensive Care?

    You and your Family may get depressed as well, because clearly, your Quality of life is suffering too, especially since you and your Family spend far too much time in Intensive Care and you may find yourself in a situation where you are neglecting your Family and personal life, you may be neglecting your children or elderly parents and you may be dealing with loss of income, since you had to take time off work, in order to spend time with your critically ill loved one in Intensive Care. In fact you might be close to a nervous breakdown because of all the stress you are experiencing!

    Furthermore, what also often happens during a long-term stay in Intensive Care is that often all parties involved get frustrated, especially if there is little or no progress.

    Two steps forward, one step back

    And what also happens during a long-term stay in Intensive Care is that more often than not, your loved one might take two steps forward and one step back. Or your critically ill loved one might take one step forward or two steps back.

    In any case, if your critically ill loved one has been in Intensive Care for any period above two to three weeks in Intensive Care, the experience is generally a frustrating one and the patience and beliefs of all parties involved are tested.

    And the reality is that if the long-term stay of your critically ill loved one in Intensive Care is getting too burdensome and difficult that the Intensive Care team may not be prepared to invest more time, resources and patience into the recovery of your critically ill loved one.

    Is it perceived as “sexy” to treat a long term Patient in Intensive Care or are there any other “hidden” agendas?

    Because dealing with a “long-term ventilated Patient” may not be perceived as “sexy” by the Intensive Care team.

    What do I mean by that?

    The reality and the fact of the matter is that at any given time in Intensive Care there are a lot of moving parts “behind the scenes” that you and your Family have no idea and insights about and the Intensive Care team is certainly not shedding any light on any of the mostly hidden “behind the scenes” stuff and if anything they try and hide it from you.

    A classic example would be that if your critically ill loved one has been in Intensive Care for two months and is struggling to come off the ventilator and is depressed, has no quality of life and desperately wants to get out of Intensive Care, but can’t because of the ventilator dependency, the Intensive Care team might come to you and might “sell” to you that your critically ill loved one’s prognosis and diagnosis is really poor and that a ”withdrawal of treatment” or a “limitation of treatment” would be “in the best interest” for your critically ill loved one!

    Research is a Million $$$ Industry in Intensive Care and the Intensive Care team has a high interest in treating Patients that fall into research categories

    What you also don’t know is that your critically ill loved one may not fall into a research category that the Intensive Care team is interested in and is getting funding for(research is a Million $$$ Industry in Intensive Care), however the bed and other resources that your critically ill loved one is currently occupying and using may better used for a Patient or for Patients that the Intensive Care team has a higher priority and interest in treating, for obvious reasons.

    What you also don’t know is that the Intensive Care has multiple planned admissions scheduled for the days to come and the Intensive Care team knows that resources are going to be stretched in the next few days.

    What you also don’t know is that the Intensive Care thinks that you and your Family have not asked too many difficult questions so far and that you have been very agreeable and cooperative, therefore the Intensive Care team thinks that they can easily “sell” to you that a “withdrawal of treatment” and/or a “limitation of treatment” might be “in the best interest” for your critically ill loved one. The Intensive Care team thinks that you and your Family are “easy prey” so to speak.

    The Intensive Care team think it’s not “sexy” to continue treating your critically ill loved one

    The Intensive Care team also secretly thinks that it’s not “sexy” to continue treating your critically ill loved one and they want to focus more on Patients that turn over relatively quickly in Intensive Care. The Intensive Care team thinks that this is “sexy”… The Intensive Care team also has this perception that high acuity Patients who require the latest technology such as ECMO may be more interesting and more “sexy” to deal with…

    The reality is that there are genuine alternatives to a long-term stay in Intensive Care

    The Intensive Care team also doesn’t often want to tell you that there are genuine options for long-term ventilated Patients with Tracheostomy in Intensive Care such as Intensive Home Care Nursing services who specialise and provide Intensive Home Care services for long-term ventilated Adults& Children with Tracheostomy in Intensive Care such as INTENSIVE CARE AT HOME in Australia (www.intensivecareathome.com.au) .

    Other countries such as Germany, Austria and Switzerland have also embraced this far more Patient and Family friendly alternative to a long-term stay in Intensive Care a long time ago. Unfortunately many English speaking countries are lacking behind in those areas with the detriment of Patients and their Families being left without an alternative but to stay in Intensive Care

    • Indefinitely
    • Getting “sold” on the idea that a “withdrawal of treatment” or a “limitation of treatment” would be “in the best interest” of your critically ill loved one

    The reality is that ventilation at home with Tracheostomy is a positive reality already and it can be used in many situations, whether it be for

    • Weaning your critically ill loved one off the ventilator
    • Having your loved one at home if they require permanent ventilation
    • And end of life situation where you, your Family and your critically ill loved one want to spend more time at home

    Therefore you and your Family need to question the assumptions of the Intensive Care team and you also need to start asking questions and you need to demand more from the Intensive Care team.

    I really hope that this blog helps you to put things into perspective if your loved one is critically ill in Intensive Care and requires a long term stay in Intensive Care and the bottom line is that if you don’t have any control, power and influence whilst your loved one is critically ill in Intensive Care that the Intensive Care team will drive their agenda and will drive the bus.

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    Is it “SEXY” for the Intensive Care team to treat your loved one who requires a long-term stay in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/sexy-intensive-care-team-treat-loved-one-requires-long-term-stay-intensive-care/feed/ 0 http://youtu.be/MPRqMFreM2s https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Is+it++sexy++for+the+ICU+team+to+treat+your+loved+one+who+requires+a+long-term+stay+in+ICU-.mp3 - Hi, http://youtu.be/MPRqMFreM2s https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Is+it++sexy++for+the+ICU+team+to+treat+your+loved+one+who+requires+a+long-term+stay+in+ICU-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOT... intensiv yes
    My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused http://intensivecarehotline.com/husband-severe-pneumoniawas-ventilatedheavily-sedated-icu-now-hes-confused/ http://intensivecarehotline.com/husband-severe-pneumoniawas-ventilatedheavily-sedated-icu-now-hes-confused/#comments Mon, 17 Feb 2014 20:00:12 +0000 http://intensivecarehotline.com/?p=5129 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+husband+has+severe+pneumonia%2Cwas+ventilated%26heavily+sedated+in+the+ICU%2C+now+he%27s+confused.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I wrote about “How long can you keep a critically ill Patient in Intensive Care in an induced coma?” Check it out here.

    In this week’s episode of your questions answered I want to answer another question of one of our reader’s whose husband is in Intensive Care after an induced coma, off the ventilator and is now confused.

    Jelena from Toronto, Canada

    Hi Patrik,

    My husband has had severe pneumonia and was on a breathing tube for several days and was heavily sedated in the ICU.

    His condition is improving and he had been taken off the ventilator.  The issue is that although he has been off the ventilator and has been now awake for about 5 days, he is still very confused, agitated and not cooperative.  The psychiatrists are medicating him with very strong medication (anti-psychosis meds) to calm him down.  He is not sleeping and is not eating.

    In some moments he does recognize me and asks about our daughter.  Other times, he is not sure what is happening, is confused and mumbles a lot.

    I am curious why he is being given such strong medication.  Can any of this medication be substituted?  Is it normal that he’s acting that way?  How long can this last?

    Is there anything else I can do?

    Thank you,

     

    Dear Jelena,

    thank you for your email.

    I appreciate the time you are taking to write this email and I understand the emotional pain and the frustration you are going through in this difficult and challenging time in your, your husband’s and in your Family’s life.

    In order to answer your questions that relate to your husband’s situation there are a few things that can happen in Intensive Care after a prolonged induced coma.

    • “waking up” is not linear or “straight forward” because of all the sedatives and opiates that have been given and accumulated during the induced coma in your loved one’s body
    • the body system needs to “get rid” of all the drugs and medications in the body system first before your husband will “make sense” again
    • Furthermore, keep in mind that if your husband has been in Intensive Care with Pneumonia, ventilated and in an induced coma, that he has been quite sick. Therefore he has been weak and his health has just been compromised big time. The sickness and the induced coma are most likely causing the situation your loved one is in
    • The confusion, agitation and non- cooperation is often also triggered by the environment, with other people being in control, the sickness and just by simply everything that’s going on in a busy Intensive Care Unit
    • You must know that a large percentage of ICU Patients after an induced coma are not waking “properly” and they are often not “waking up” as quick as you and the Intensive Care team would like them to wake up, but it’s nothing unusual and it happens all the time in Intensive Care
    • Moreover, you don’t say how old your husband is, however generally speaking, the older Patients are, the higher the risk and the likelihood that “waking up” after an induced coma is getting delayed and more difficult. Also know that many ICU Patients go through the “ICU related Psychosis” phase, just simply as a result of being in ICU, by being sick and by being on a ventilator/ respirator and in an induced coma
    • The good thing that I can see in your situation is that at least your husband is off the ventilator/ respirator and it sounds to me like he is able to stay off the ventilator/ respirator, which is a very good thing and is probably also more important than the confusion, agitation and non- cooperation. The last thing you would want is to have your husband go back on a ventilator/ respirator
    •  In regards to your loved one getting strong medication(anti- psychosis meds) to manage his confusion, agitation and non- cooperation, you need to know a few things. My experience has shown that Intensive Care teams tends to be very quick in giving those “behavioural” drugs(anti- psychosis meds) in order to “manage” your loved one. I am personally not a huge friend of those drugs, however I’m also aware of the limitations of non- medication management if Patients are confused, agitated and non- cooperative. Therefore, if the Intensive Care team has tried to manage your husband with their communication skills and their expertise and have failed, their next step is to give him anti- psychotic drugs such as Haloperidol, Clonidine, Olanzepine or Diazepam(Valium) to name a few. The problem often is that by giving those drugs that your husband gets “knocked out” and very sleepy to the point where the situation may actually get worse before it actually gets better. There is also the risk of your husband getting too sleepy so that he would have to be put back on a ventilator/ respirator again.

    Normally, as a first step after the induced coma, it is very important that the Intensive Care team gets your husband into a “normal” routine and I have found that it is very important to take good care of your husband’s hygiene needs such as brushing teeth and doing regular mouth care, but also things like regular washes and a shower can do wonders and is often the better path, compared to managing the situation with drugs.

    Good nursing care can make a big difference!

    Do you think that your husband is getting good nursing care? Also think about things like getting some natural daylight if he’s in a room without natural daylight. Do you think that the Intensive Care team has considered any of it? If you find that they have, great and if you find that they haven’t ask for it and don’t be shy about it!

    You also mentioned that your husband has lost appetite, which is nothing unusual in ICU, however is the Intensive Care team giving him some nutrition via a feeding tube or intravenously? Have they considered this? Also, if he likes any specific food, bring it in and give it to him. Nutrition can help as well, especially if he’s weak.

    Sometimes, however even good nursing care might not help and then medication management with anti- psychosis meds might be indicated but it should be the last resort. If you find that all other attempts to manage the situation have failed then medication management is the right thing to do and your patience will be tested. Normally it takes a good few days until your husband will be “normal” and cooperative again. Very rarely have I seen confusion, agitation and non- cooperation seen last for longer than 7 days, however those 7 days can be a test to your patience of course.

    Other things you can do are things like playing his favourite music, bring pictures of your loved ones, familiar tastes, smells etc… might also help to get your husband back to normal.

    Also check out this blog post here to give you more insight about confusion, agitation and delirium in Intensive Care(click on the link below)  “5 things you need to know if your critically ill loved one is confused, agitated and delirious in Intensive Care”

    I hope that this helps and please let me know if you have any other questions.

    I would also be available to have a chat on Skype if you need more help.

    You also should get more education about Intensive Care as otherwise the Intensive Care team will put their agenda on you and your critically ill loved one and you wind up with no power, control and influence.

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused is a post from: INTENSIVE CARE HOTLINE

    The post My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused appeared first on INTENSIVE CARE HOTLINE.

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    http://intensivecarehotline.com/husband-severe-pneumoniawas-ventilatedheavily-sedated-icu-now-hes-confused/feed/ 0 http://youtu.be/IGxM-Zq3HCk https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+husband+has+severe+pneumonia%2Cwas+ventilated%26heavily+sedated+in+the+ICU%2C+now+he%27s+confused.mp3 - Hi, http://youtu.be/IGxM-Zq3HCk https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+husband+has+severe+pneumonia%2Cwas+ventilated%26heavily+sedated+in+the+ICU%2C+now+he%27s+confused.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I wrote about “How long can you keep a critically ill Patient in Intensive Care in an induced coma?” Check it out here (http://intensivecarehotline.com/long-can-keep-critically-ill-patient-intensive-care-induced-coma/). In this week’s episode of “your questions answered” I want to answer another question of one of our reader’s whose husband is in Intensive Care after an induced coma, off the ventilator and is now confused. Jelena from Toronto, Canada Hi Patrik, My husband has had severe pneumonia and was on a breathing tube for several days and was heavily sedated in the ICU. His condition is improving and he had been taken off the ventilator.  The issue is that although he has been off the ventilator and has been now awake for about 5 days, he is still very confused, agitated and not cooperative.  The psychiatrists are medicating him with very strong medication (anti-psychosis meds) to calm him down.  He is not sleeping and is not eating. In some moments he does recognize me and asks about our daughter.  Other times, he is not sure what is happening, is confused and mumbles a lot. I am curious why he is being given such strong medication.  Can any of this medication be substituted?  Is it normal that he’s acting that way?  How long can this last? Is there anything else I can do? Thank you,   Dear Jelena, thank you for your email. I appreciate the time you are taking to write this email and I understand the emotional pain and the frustration you are going through in this difficult and challenging time in your, your husband's and in your Family's life. In order to answer your questions that relate to your husband's situation there are a few things that can happen in Intensive Care after a prolonged induced coma. * "waking up" is not linear or "straight forward" because of all the sedatives and opiates that have been given and accumulated during the induced coma in your loved one's body * the body system needs to "get rid" of all the drugs and medications in the body system first before your husband will "make sense" again * Furthermore, keep in mind that if your husband has been in Intensive Care with Pneumonia, ventilated and in an induced coma, (http://intensivecarehotline.com/induced-coma-critically-ill-loved-one-induced-coma/) that he has been quite sick. Therefore he has been weak and his health has just been compromised big time. The sickness and the induced coma are most likely causing the situation your loved one is in * The confusion, agitation and non- cooperation is often also triggered by the environment, with other people being in control, the sickness and just by simply everything that's going on in a busy Intensive Care Unit * You must know that a large percentage of ICU Patients after an induced coma are not waking "properly" and they are often not "waking up" as quick as you and the Intensive Care team would like them to wake up, but it's nothing unusual and it happens all the time in Intensive Care * Moreover, you don't say how old your husband is, however generally speaking, the older Patients are, the higher the risk and the likelihood that "waking up" after an induced coma is getting delayed and more difficult. Also know that many ICU Patients go through the "ICU related Psychosis" phase, intensiv yes
    The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care! http://intensivecarehotline.com/3-phrases-must-always-use-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/3-phrases-must-always-use-loved-one-critically-ill-intensive-care/#comments Sun, 16 Feb 2014 20:00:53 +0000 http://intensivecarehotline.com/?p=5127 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/The+3+phrases+you+must+ALWAYS+use+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

    The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “How believing in yourself will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care” You can read, watch or listen to the update here.

    In this week’s blog I want to show you “The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care!”.

    Getting overwhelmed by negative emotions is easy…

    It’s very easy to get bogged down if one of your Family members has just been admitted to Intensive Care for critical illness. It’s even easier to get overwhelmed by negative emotion if your loved one has just been admitted to Intensive Care!

    And it’s a big problem for Families of critically ill Patients in Intensive Care! And it’s a problem that is so big that Families of critically ill Patients don’t know left from right and don’t know right from wrong.

    The negative emotions and the feeling of powerlessness, the loss of control and the feeling of having no influence whatsoever whilst your loved one is critically ill in Intensive Care usually goes hand in hand with the feeling of overwhelm, fear, frustration, struggle and the feeling of vulnerability.

    It also makes it very easy for the Intensive Care team to drive the bus and present your critically ill loved one’s prognosis and diagnosis in a light that suits the Intensive Care team’s agenda and may or may not represent reality.

    If your critically ill loved one is a “straight forward” admission to Intensive Care and is soon to be discharged from Intensive Care, that’s great news and you can probably stop reading here now, because what I am about to share applies more to Families where their critically ill loved one is either

    • dying
    • Very unstable and in a really critical condition
    • Very unstable and on the brink of dying
    • Stable but a long-term stay in Intensive Care may be on the horizon
    • Unstable and a long term stay in Intensive Care may be on the horizon
    • A long term Patient in Intensive Care

    In essence, what I am about to share is for any Family member of a critically ill Patient in Intensive Care who is not “a straight forward Patient” and who is in Intensive Care with an uncertain short term or long term future.

    Why your thinking may hold you back

    Therefore, you and your Family need to get back on track and you need to take charge and control of the situation immediately!

    The reality is that there are so many moving parts behind the scenes in Intensive Care that you have no idea and insights about and if you don’t educate yourself quickly, it’s very easy for the Intensive Care team to drive their agenda, especially if your loved one falls into one of the categories that I mentioned above!

    In more than 15 years Intensive Care nursing in three different countries I have found that 99% of Families of critically ill Patients in Intensive Care are generally so overwhelmed by fear, frustration, struggle and vulnerability that the last thing on their mind is that they can take control, have power and influence in the situation, because they have this misconception that the Intensive Care team holds all the power. And the Intensive Care team holds all the power if you let them and if you think that they have all the power!

    The next big challenge for Families of critically ill Patients is that they don’t educate themselves about Intensive Care and it’s therefore very easy for the Intensive Care team to drive their agenda and position themselves and your critically ill loved one’s prognosis and diagnosis in a light that suits the Intensive Care team.

    Your job therefore is to position yourself and your Family correctly in such a challenging and often “once in a lifetime” situation.

    Therefore I want to give you three power phrases that you must always use whilst your loved one is critically ill in Intensive Care!

    1.       I am/ we are able to take control of the situation, no matter what!

    Listen, it’s so easy to get frustrated and overwhelmed by this challenge and it’s even easier to put all your trust in the Intensive Care team… But if you are facing a massive challenge like the ones I mentioned above where your loved one is dying or at least the Intensive Care team is telling you that your critically ill loved one is dying, or if the Intensive Care team is telling you that your critically ill loved one may have to stay in Intensive Care for long periods of time with an uncertain outcome, you better find out whether they are telling you the truth…

    The reality is that in a Billion Dollar $$$ industry such as Intensive Care, the Intensive Care team will always have an agenda, whether it’s their research interests(equals Million Dollar $$$ funding), bed management, staffing crisis and/or the Intensive Care Unit’s budget, your job is to make sure that you take control of the situation by asking the right questions, by challenging the Intensive Care team and by believing that you can have control, power and influence!

    2.       I am/ we are able to have power in this challenging situation, no matter what!    

    If you are like 99% of Families of critically ill Patients in Intensive Care you think that the Intensive Care team is powerful and you therefore think that you and your Family have no power in this situation whatsoever! If you are like 99% of Families of critically ill Patients you also put the Intensive Care team on a pedestal and you tend to “suck up” to them and you think that “they must be really smart”.

    If you hopefully belong to the 1% of Families of critically ill Patients in Intensive Care who have control, power and influence you have hopefully already challenged the assumption that the Intensive Care team has all the power and you have hopefully challenged your own assumptions about your own ability to have control, power and influence in this challenging situation, because the reality is that if you think that if you have control, power and influence you probably have.

    Therefore, stop “sucking up” to the Intensive Care team and drive your own agenda. See what happens. I bet the Intensive Care team won’t like it. I also bet that if they don’t like it, they have something to hide or they are so used to not have Families challenge them that they can’t deal with the situation. The reality is that if you start challenging the Intensive Care team and if you start asking the right questions, you will have control, power and influence and you immediately set yourself apart from 99% of Families of critically ill Patients who don’t have control, power and influence! You will also see the dynamics shift in your favour immediately! You can trust me on this one!

    3.       I am/ we are able to have influence in this challenging and often “once in a lifetime” situation!

    Again, if you are like 99% of Families of critically ill Patients in Intensive Care, you feel like you have no or very little influence in this challenging and often “once in a lifetime” situation.

    Think about it.

    Thankfully, it’s not very often that one of your Family members gets admitted to Intensive Care. But if you and your Family have found yourself in this challenging situation you don’t want to leave things up to the Intensive Care team alone! Your input and your level of influence is crucial!

    Especially if the Intensive Care team hasn’t told you any good news and especially if you feel like things are getting out of control.

    Once again, if the Intensive Care team has told you that your critically ill loved one is

    • dying
    • Very unstable and in a really critical condition
    • Very unstable and on the brink of dying
    • Stable but a long-term stay in Intensive Care may be on the horizon
    • Unstable and a long term stay in Intensive Care may be on the horizon
    • Becoming a long term Patient in Intensive Care

    Your job is to question the Intensive Care team’s very assumptions and you quickly need to find out whether they are telling you the truth or whether there are other moving parts and other motives driving their agenda such as research activities, bed management, the Intensive Care budget, staffing issues and/or other competing interests.

    How do you do that and how do you educate yourself quickly, succinctly and efficiently so that you have control, power and influence?

    I’m glad you’ve asked! Because here it is…

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

    The post The 3 phrases you must ALWAYS use if your loved one is critically ill in Intensive Care! appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/3-phrases-must-always-use-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/l6ma3kMDDh8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/The+3+phrases+you+must+ALWAYS+use+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE. http://youtu.be/l6ma3kMDDh8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/The+3+phrases+you+must+ALWAYS+use+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE... intensiv yes
    How long can you keep a critically ill Patient in Intensive Care in an induced coma? http://intensivecarehotline.com/long-can-keep-critically-ill-patient-intensive-care-induced-coma/ http://intensivecarehotline.com/long-can-keep-critically-ill-patient-intensive-care-induced-coma/#comments Mon, 10 Feb 2014 20:07:25 +0000 http://intensivecarehotline.com/?p=5059 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+you+keep+a+critically+ill+Patient+in+Intensive+Care+in+an+induced+coma-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    How long can you keep a critically ill Patient in Intensive Care in an induced coma? is a post from: INTENSIVE CARE HOTLINE

    The post How long can you keep a critically ill Patient in Intensive Care in an induced coma? appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered another question of one of our readers and the reader’s question was about their mother’s liver failure and a possible Tracheostomy in Intensive Care. Check it out here.

    In this week’s episode of “your questions answered” I want to answer another question that we get asked quite frequently from our readers and the question is “How long can you keep a critically ill Patient in Intensive Care in an induced coma?”

    If your loved one is critically ill in Intensive Care and is also in an induced coma, chances are that you and your Family want to know how long your critically ill loved one might stay in the medically induced coma.

    As a rule of thumb, you also need to know that a medically induced coma always goes hand in hand with mechanical ventilation on a ventilator or respirator.

    Furthermore, you also need to know that the reasons to induce your critically ill loved one into an induced coma are generally speaking not only to have your loved one tolerate the ventilator and the breathing tube and it’s usually also a measure of giving your loved one’s body a rest during the critical illness. Without an induced coma, your critically ill loved one would be unable to tolerate the ventilator and the breathing tube as this is extremely uncomfortable and without the induced coma certain vital body functions such as breathing and ventilation could be inadequate and could lead to further deterioration of your critically ill loved one.

    Keep in mind that whatever the reason for the admission to Intensive Care is, your loved one is critically ill after all and many vital body organs and systems have shut down and therefore need a rest. Therefore a medically induced coma can help your loved one on their way to recovery and may be the right thing to do.

    The following admission scenarios to Intensive Care most often lead to a medically induced coma and ventilation

    The list is not exhaustive however it lists the most common admission scenarios to Intensive Care that is followed by mechanical ventilation and a medically induced coma.

    So the question now is how long can your critically ill loved one stay in an induced coma?

    Well, the answer is that it depends. Normally a medically induced coma shouldn’t last for much longer than a few days and given that ventilation with a breathing tube and the induced coma comes with risks, the time in an induced coma and on a ventilator should be minimized as much as possible.

    Therefore, as soon as the Intensive Care team thinks that your loved one is on their way to recovery and is able to be “woken up” out of the induced coma, your loved one should be taken off the sedative and opiate(pain killers) drugs that keep your loved one in the induced coma.

    Taking your critically ill loved one out of an induced coma and weaning them off the ventilator/respirator is often not a straight forward or linear process. Often people think that after your loved one has been taken out of the induced coma they will be taken off the ventilator straight away.

    The rule rather than the exception is that taking your critically ill loved one out of the induced coma is like switching on a light with a dimmer rather than switching on a light with a light switch. It’s often a gradual and slow process and can sometimes take many days before your critically ill loved one is fully awake and can be taken off the ventilator/ respirator.

    Again, as a rule of thumb, depending on your critically ill loved one’s admission scenario to Intensive Care, they shouldn’t really be in an induced coma for more than one week at the very most. Of course, again, there’s always the exception to the rule, however you need to keep in mind that a prolonged induced coma has undesired side effects such as

    • Immobility and muscle weakness
    • The accumulation of sedative and opiate(pain killer) drugs in your loved one’s body that delay the “waking up” process even after the sedative and opiate drugs have been reduced or switched off completely- this is also often the reason why your critically ill loved one can’t be taken off the ventilator straight away
    • That some of the sedative and opiate drugs(pain killers) such as Midazolam, Morphine or Fentanyl have undesired side effects such as addiction and nightmares. It’s one of the reasons why “waking up” out of the induced coma can be difficult. The longer your critically ill loved one is kept in an induced coma, the higher the risk that your loved one may have to be weaned off some sedative drugs as they are addictive in their very nature
    • The longer your critically ill loved one is in an induced coma and immobile with the muscles getting weaker the higher are the risks of complications such as developing Pneumonia, Thrombosis and pressure sores

    The induced coma can be ongoing for many weeks at times but should be minimized as much as possible

    Having said all of that, an induced coma can be ongoing for many weeks at times, depending on the medical issues that brought your critically ill loved one into Intensive Care in the first place. If the medically induced coma and mechanical ventilation with a breathing tube is ongoing then the next step might be to perform a Tracheostomy. With a Tracheostomy in place it enables the Intensive Care team to reduce, minimize or switch off the sedative and opiate drugs completely and wean your critically ill loved one off the ventilator. A Tracheostomy usually makes weaning off the ventilator much easier, but should only be considered if the induced coma is prolonged and ongoing and/or if weaning off the ventilator has failed or is likely to fail.

    If your critically ill loved one is very unstable and is fighting ventilation and the breathing tube and is at the same time not ready to breathe by themselves, then they might stay in the induced coma until they either can be either weaned off the ventilator/ respirator or until a Tracheostomy can be performed in case your critically ill loved one can’t be weaned off the ventilator/ respirator. The good news generally is that as soon as a Tracheostomy has been performed, your loved one should be able to be taken out of the induced coma and sedative and opiate drugs should be drastically reduced.

    Again, your job as a family member or friend of a critically ill loved one is to ask as many questions as possible to the Intensive Care team and your job is also to make sure that your loved one doesn’t stay in the induced coma for longer than necessary, due to the risks associated with it. Some Intensive Care teams and Intensive Care Units are more risk averse than others and therefore may keep your critically ill loved one in an induced coma for longer than necessary.

    You may have heard about the recent skiing accident that the famous German Formula 1 driver and former world champion Michael Schuhmacher was involved in the French alps. He hit his head on a rock and he ended up with severe head injuries and by the time I’m writing this he has been in an induced coma for more than a month now.

    Especially with severe head injuries or severe brain injuries, a prolonged induced coma might help your critically ill loved one to recover and it might also help the brain to recover, reduce swelling inside the brain and just minimizes any movement that might be detrimental to your critically ill loved one’s recovery.

    Check out this article for more information about induced coma in head or brain injuries(click on the link):

    How long will my critically ill loved one in an induced coma for after a brain or head injury?

    Also find more related articles for induced coma and Tracheostomy at the end of the blog.

    Also, keep in mind that your job is to be the advocate of your critically ill loved one and your job is to have as much control, power and influence whilst your loved one is critically ill in Intensive Care, because most Intensive Care teams are not really tuning into the needs of Families of critically ill Patients and they are very much used to having and holding all the power with families of critically ill Patients in Intensive Care. Your job is to turn the perceived power dynamics around so that you have control, power and influence.

    How do you do that and how can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    I’m glad you’ve asked.

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

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    How long can you keep a critically ill Patient in Intensive Care in an induced coma? is a post from: INTENSIVE CARE HOTLINE

    The post How long can you keep a critically ill Patient in Intensive Care in an induced coma? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/long-can-keep-critically-ill-patient-intensive-care-induced-coma/feed/ 0 http://youtu.be/56Im8ToCneA https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+you+keep+a+critically+ill+Patient+in+Intensive+Care+in+an+induced+coma-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/56Im8ToCneA https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+you+keep+a+critically+ill+Patient+in+Intensive+Care+in+an+induced+coma-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered another question of one of our readers and the reader’s question was about their mother’s liver failure and a possible Tracheostomy in Intensive Care (http://intensivecarehotline.com/liver-failure-question-tracheostomy/). Check it out here (http://intensivecarehotline.com/liver-failure-question-tracheostomy/). In this week’s episode of “your questions answered” I want to answer another question that we get asked quite frequently from our readers and the question is “How long can you keep a critically ill Patient in Intensive Care in an induced coma?” If your loved one is critically ill in Intensive Care and is also in an induced coma, chances are that you and your Family want to know how long your critically ill loved one might stay in the medically induced coma. As a rule of thumb, you also need to know that a medically induced coma always goes hand in hand with mechanical ventilation on a ventilator or respirator. Furthermore, you also need to know that the reasons to induce your critically ill loved one into an induced coma are generally speaking not only to have your loved one tolerate the ventilator and the breathing tube and it’s usually also a measure of giving your loved one’s body a rest during the critical illness. Without an induced coma, your critically ill loved one would be unable to tolerate the ventilator and the breathing tube as this is extremely uncomfortable and without the induced coma certain vital body functions such as breathing and ventilation could be inadequate and could lead to further deterioration of your critically ill loved one. Keep in mind that whatever the reason for the admission to Intensive Care is, your loved one is critically ill after all and many vital body organs and systems have shut down and therefore need a rest. Therefore a medically induced coma can help your loved one on their way to recovery and may be the right thing to do. The following admission scenarios to Intensive Care most often lead to a medically induced coma and ventilation * Pneumonia (http://intensivecarehotline.com/clinical-pictures/pneumonia/) * Open heart surgery (http://intensivecarehotline.com/clinical-pictures/coronary-artery-bypass-graft-cabg/) * Stroke (http://intensivecarehotline.com/clinical-pictures/stroke/) * Sepsis (http://intensivecarehotline.com/clinical-pictures/sepsis/)(globalised severe infection often resulting in multi-organ failure) * Severe head or brain injuries (http://intensivecarehotline.com/clinical-pictures/traumatic-brain-injury-tbi/) * Multi-trauma (http://intensivecarehotline.com/clinical-pictures/multi-trauma/) * Heart attack (http://intensivecarehotline.com/clinical-pictures/heart-attackacute-myocardial-infarction/) * Heart failure (http://intensivecarehotline.com/clinical-pictures/heart-failure/) * Cardiac arrest (http://intensivecarehotline.com/clinical-pictures/cardiac-arrest/) * Abdominal Aneurysm repair (http://intensivecarehotline.com/clinical-pictures/abdominal-aortic-aneurysm-2/) * ARDS (http://intensivecarehotline.com/clinical-pictures/adult-respiratory-distress-syndrome-ards/) or lung failure * Drug overdose (http://intensivecarehotline.com/clinical-pictures/drug-overdose/) * Guillan- Barre syndrome (http://intensivecarehotline.com/clinical-pictures/guillain-barre-syndrome/) * Liver failure intensiv yes
    How BELIEVING IN YOURSELF will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care http://intensivecarehotline.com/believing-will-help-control-power-influence-whilst-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/believing-will-help-control-power-influence-whilst-loved-one-critically-ill-intensive-care/#comments Sun, 09 Feb 2014 20:00:35 +0000 http://intensivecarehotline.com/?p=5054 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Believe+in+yourself+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! In last […]

    How BELIEVING IN YOURSELF will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “The 3 ways on how to turn the tables in your favour and have control, power and influence whilst your loved one is critically ill in Intensive Care!” You can read, watch or listen to the blog by clicking on the link here.

    In this week’s blog I want to show you “How believing in yourself will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care”

    If your loved one has been admitted to Intensive Care for critical illness I bet that fear, frustration, stress, struggle, challenge, the feeling of vulnerability, loss of control, the feeling of powerlessness and the lack of influence are all things you can resonate with.

    The biggest imprint left on you and your Family are probably the lack of control, the lack of power and the lack of influence. Furthermore, with the Intensive Care holding all the perceived power whilst your loved one is critically ill in Intensive Care, you can feel a big void and a big gap between the perceived power the Intensive Care team holds and the perceived power you and your Family hold whilst your loved one is critically ill in Intensive Care.

    The perceived power struggle and what you need to do about it
    Certainly, this power struggle is only perceived and a lot of it simply depends on your mindset and if you are like 99% of Families of critically ill Patients in Intensive Care you will simply never have any control, power and influence, because those Families simply think that they can’t have control, power and influence. Again, their mindset is holding them back and it’s easy for the Intensive Care team to drive their agenda and keep you at arm’s length so to speak.

    Start with your “inner game” and inner beliefs
    There is very little that you can change in the perceived power dynamics between the Intensive Care team and you, your Family and your critically ill loved one, unless you start with your “inner game” so to speak and with your inner beliefs.

    Those 1% of Families of critically ill Patients in Intensive Care who have control, power and influence are able to change the perceived power dynamics between the Intensive Care team and themselves, because they simply believe that they can. And those interactions between the Families who believe that they have control, power and influence and the Intensive Care team are very different from the start. The Intensive Care team recognizes your beliefs and your vibe and they very rarely question those dynamics, because they realize that those Families simply have control, power and influence. It’s tangible and it’s real.

    What’s the difference you may ask?
    Henry Ford once famously said: “Whether you think you can or you can’t, you’re absolutely right!”
    The bottom line here is very simple and if you believe that you have control, power and influence in such a difficult and challenging situation, you simply will have control, power and influence and if you think that you don’t or that you can’t have any control, power and influence in a situation where your behaviour and beliefs can significantly impact your critically ill loved one’s outcomes and recovery, you simply won’t have any control, power and influence.

    If you belong to the 99% of Families of critically ill Patients in Intensive Care who don’t have any power, control and influence, good luck to you. The Intensive Care team will only tell you half of the truth of what’s really happening. And the bottom line is that your critically ill loved one may not get the best possible treatment.

    If you believe in yourself, the Intensive Care team will take notice
    If you belong to that tiny 1% bracket of Families who do have control, power and influence your critically ill loved one and the Intensive Care team will consciously or unconsciously feel the positive vibes and determination coming from you and I bet that whatever the odds are, you and your Family will have a much bigger impact on how the Intensive Care team treats you, your Family and your critically ill loved one.

    Don’t be paralysed by fear, frustration and by the perceived power that the Intensive Care team holds and take charge of your believes! Often the only thing you can control in such a difficult and challenging situation are your thoughts and your beliefs.

    To give you a quick real world example where I have been involved in a few years back:
    A man in his 70is was once admitted to Intensive Care with open heart surgery. After the surgery he had a cardiac arrest(his heart stopped) and he was resuscitated on an open chest for more than an hour. He survived but with a very poor prognosis. This man had previously suffered from a stroke and cancer and survived and recovered from both.

    On top of that he had gone into kidney failure and was now dependent on the Dialysis machine. The Intensive Care team was adamant not to continue treatment and tried to convince the Family that a “withdrawal of treatment” and a “limitation of treatment” was “in the best interest” of their critically ill loved one. In the back of their mind the Intensive Care team wanted to free up their ICU bed and they also thought that this case wasn’t a “good business case” that wouldn’t make them any money or that they would lose money.

    If the Family had been like 99% of the Families of critically ill Patients in Intensive Care, they wouldn’t have questioned the Intensive Care team’s perception of the situation and they would have agreed with the Intensive Care team, with the most likely outcome of their critically ill loved one dying.

    However, this Family belonged in the 1% bracket of Families of critically ill Patients who had control, power and influence, simply because they believed that they could have control, power and influence.
    To cut a long story short, the Family of the man in his 70is made very clear that they believed that their husband, father, grandfather and brother would survive the odds as he had done many times in the past. This Family knew their loved one well and they wouldn’t buy into the strictly clinical and academic opinions the Intensive Care team held. They followed their believes and their gut and they held lots of power, control and influence and the Intensive Care team knew it and after initial resistance the Intensive Care team would continue treating this man with a good outcome. The man recovered and left Intensive Care after a few weeks in ICU.

    The moral of the story?
    If the Intensive Care team and your critically ill loved one know that you believe in your ability to come out good from this challenge and difficult situation, they will consciously or unconsciously feel it and know it and you will be able to have control, power and influence. Do never give up.

    Imagine you don’t believe that you can have control, power and influence and imagine you don’t believe that your critically ill loved one can and will recover, what other options do you have? Trust in the Intensive Care team who has many other and often competing interests? I don’t think so.
    You controlling your thoughts and believes are often your biggest leverage points whilst your loved one is critically ill in Intensive Care.

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!
    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)
    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!
    Make sure you also check out our “your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    How BELIEVING IN YOURSELF will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

    The post How BELIEVING IN YOURSELF will help you to have control, power and influence whilst your loved one is critically ill in Intensive Care appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/believing-will-help-control-power-influence-whilst-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/Z-hXfsYB6vs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Believe+in+yourself+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/Z-hXfsYB6vs https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Believe+in+yourself+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http... intensiv yes
    My mother is in Intensive Care with Liver failure and might need a Tracheostomy, what should we do? http://intensivecarehotline.com/liver-failure-question-tracheostomy/ http://intensivecarehotline.com/liver-failure-question-tracheostomy/#comments Mon, 03 Feb 2014 20:00:51 +0000 http://intensivecarehotline.com/?p=4937 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/INTENSIVE+CARE+HOTLINE+episode+of++YOUR+QUESTIONS+ANSWERED+.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    My mother is in Intensive Care with Liver failure and might need a Tracheostomy, what should we do? is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I answered the question How long will my critically ill loved one in an induced coma for after a brain or head injury?” You can check it out here.

    In this week’s episode of your questions answered I want to answer another one of our reader’s questions and this week, Michael from Chicago, Ill, USA has the following question.

     Hi Patrik

    My 57 year old mother mother has been in ICU for three weeks now. Her liver is shut down because she is an alcoholic. She has been on a ventilator for three weeks now and the Intensive Care team wants us to make some decisions.  I am freaking out should we put her on a Tracheostomy that is what we are unsure about and that’s where I need your help please. I have another appointment in 11 hours with the doctors.

    We were at the most stressful time and my step mother found your website.  Your information had already changed how are all conducting our business with the ICU team. We cannot thank you enough. I will contact you as we move forward.  Thank you . I hope you know how valuable your website is to us.

    Furthermore, I got very angry at the Intensive Care team because the doctors keep flip flopping and now he says with therapy she could survive, but we still need your advice about where to go from here.

    Moreover, she has no insurance and I am not sure if they do have her best interest at heart. It’s a very confusing and hard time. I want to do what she wants but I wonder will she get to a point with the Tracheostomy where we can talk about what she wants considering her liver damage. She has been detoxed in the ICU here and came in convulsions.

     

    Hi Michael,

    I’m very sorry to hear what you are going through with your mother.

    If your mother has been in ICU for three weeks now and she’s still ventilated, a Tracheostomy might be the right step, especially if she has failed to be taken off the ventilator during those three weeks. Three weeks on a ventilator without a Tracheostomy is a long time and normally if weaning off the ventilator is failing within 7-10 days, a Tracheostomy should be the next step.

    If your mother is in liver failure and you think that she might be lacking the strength and stamina to go through a lengthy weaning process off the ventilator with a Tracheostomy, you might have to think about what might be next and in your mother’s best interest. Nobody can make that decision for you.

    It certainly concerns me that you think that the Intensive Care team may not have your mother’s best interest at heart. Furthermore, keep in mind that if you are unsure, that you might ask for another couple of days or even more, until you have made up your mind or gathered more information.

    As it relates to your mother having a Tracheostomy, it could well buy you, your Family and your mother time, as she may then be able to tell you what she wants.

    In regards to your mother’s liver failure, she may not survive in the long term, but I think there is a fair chance that she may get out of Intensive Care sooner or later and then she can advice you and your Family what she wants in the future, should she get readmitted back to ICU. I do think that getting your mother out of Intensive Care would be a big bonus for you, for your Family and for your mother.

    Even if she has a Tracheostomy and remains ventilator dependent she might be able to get out of Intensive Care. For (long-term) ventilator dependent Patients with Tracheostomy, often Intensive Home Care nursing, as a genuine alternative to a long-term stay in Intensive Care is the best alternative, but not always available in all areas/ countries. In Australia for example, specialized Intensive Home Care services as a genuine alternative to a long-term stay in Intensive Care are available, such as www.intensivecareathome.com.au

    From what you describe, I think you and your Family, including your mother need more time to make a decision on what might be best. Even though your mother has been in ICU for three weeks and you may think that this is a long time, in the bigger scheme of things it’s not and often Patients stay much longer before they can be discharged or before they can approach their end of life.

    You may not think of it that way, but your mother with 57 years of age is quite young and even though she’s quite sick, she still has a better chance of recovery than other, older age groups, despite her medical issues.

    As you question whether the Intensive Care team has the best interest of your mother at heart, you need to consider the following:

    I understand that she’s uninsured and the Intensive Care team can use this in two ways

    1) the Intensive Care team may suggest to continue treating her, because they may see financial viability and a “good business case” in treating her

    2) the Intensive Care team may suggest to “stop” or “limit” treatment because they may want to occupy the ICU bed with another Patient, that the Intensive Care team has a bigger interest in treating, whether it be because of financial viability or research interests etc…

    The Intensive Care team will twist and turn your mother’s case in whichever way it may suit their interests and agenda. Your job is to be aware that those dynamics exist and then question and position yourself accordingly.

    As a next step, I would think that buying a little more time before you proceed with any decisions may be the best advice I can give you, because your mother might also need a little bit more time to come out of the induced coma and she may need a little bit more time to think about what she wants. If she doesn’t “wake up” properly you might have to make decisions for her, but I don’t think that “rushing” into it is advisable. Keep in mind this is often a “once in a lifetime” situation and you don’t want to get it wrong and you don’t want to leave with a bitter taste in your mouth or without peace of mind.

    Please let me know if you need anymore help and as I said I would be happily talking with you on skype if that’s of interest to you.

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your friend

    Patrik Hutzel

    My mother is in Intensive Care with Liver failure and might need a Tracheostomy, what should we do? is a post from: INTENSIVE CARE HOTLINE

    The post My mother is in Intensive Care with Liver failure and might need a Tracheostomy, what should we do? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/liver-failure-question-tracheostomy/feed/ 0 http://youtu.be/oHUIroql44Q https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/INTENSIVE+CARE+HOTLINE+episode+of++YOUR+QUESTIONS+ANSWERED+.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/oHUIroql44Q https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/INTENSIVE+CARE+HOTLINE+episode+of++YOUR+QUESTIONS+ANSWERED+.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered the question “How long will my critically ill loved one in an induced coma for after a brain or head injury?” You can check it out here (http://intensivecarehotline.com/long-will-critically-ill-loved-one-induced-coma-brain-head-injury/). In this week’s episode of “your questions answered” I want to answer another one of our reader’s questions and this week, Michael from Chicago, Ill, USA has the following question.  Hi Patrik My 57 year old mother mother has been in ICU for three weeks now. Her liver is shut down because she is an alcoholic. She has been on a ventilator for three weeks now and the Intensive Care team wants us to make some decisions.  I am freaking out should we put her on a Tracheostomy that is what we are unsure about and that’s where I need your help please. I have another appointment in 11 hours with the doctors. We were at the most stressful time and my step mother found your website.  Your information had already changed how are all conducting our business with the ICU team. We cannot thank you enough. I will contact you as we move forward.  Thank you . I hope you know how valuable your website is to us. Furthermore, I got very angry at the Intensive Care team because the doctors keep flip flopping and now he says with therapy she could survive, but we still need your advice about where to go from here. Moreover, she has no insurance and I am not sure if they do have her best interest at heart. It’s a very confusing and hard time. I want to do what she wants but I wonder will she get to a point with the Tracheostomy where we can talk about what she wants considering her liver damage. She has been detoxed in the ICU here and came in convulsions.   Hi Michael, I’m very sorry to hear what you are going through with your mother. If your mother has been in ICU for three weeks now and she's still ventilated, a Tracheostomy might be the right step, especially if she has failed to be taken off the ventilator during those three weeks. Three weeks on a ventilator without a Tracheostomy is a long time and normally if weaning off the ventilator is failing within 7-10 days, a Tracheostomy should be the next step. If your mother is in liver failure and you think that she might be lacking the strength and stamina to go through a lengthy weaning process off the ventilator with a Tracheostomy, you might have to think about what might be next and in your mother’s best interest. Nobody can make that decision for you. It certainly concerns me that you think that the Intensive Care team may not have your mother’s best interest at heart. Furthermore, keep in mind that if you are unsure, that you might ask for another couple of days or even more, until you have made up your mind or gathered more information. As it relates to your mother having a Tracheostomy, it could well buy you, your Family and your mother time, as she may then be able to tell you what she wants. In regards to your mother's liver failure, she may not survive in the long term, but I think there is a fair chance that she may get out of Intensive Care sooner or later and then she can advice you and your Family what she wants in the future, should she get readmitted back to ICU. I do think that getting your mother out of Intensive Care would be a big bonus for you, for your Family and for your mother. intensiv yes
    Podcast interview with Medical Futility expert and lawyer Professor Thaddeus Pope http://intensivecarehotline.com/podcast-interview-professor-thaddeus-pope/ http://intensivecarehotline.com/podcast-interview-professor-thaddeus-pope/#comments Sun, 02 Feb 2014 20:00:45 +0000 http://intensivecarehotline.com/?p=4878 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/prof+pope+interview.m4a In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Professor Thaddeus Pope a US based lawyer and medical futility expert! Professor Pope is especially concerned with exploring the justifiability of private and public limitations on individual liberty, end-of-life medicine and public health ethics. In this episode you’ll discover why technology advances faster than our values […]

    Podcast interview with Medical Futility expert and lawyer Professor Thaddeus Pope is a post from: INTENSIVE CARE HOTLINE

    The post Podcast interview with Medical Futility expert and lawyer Professor Thaddeus Pope appeared first on INTENSIVE CARE HOTLINE.

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    https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/prof+pope+interview.m4a

    In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Professor Thaddeus Pope a US based lawyer and medical futility expert! Professor Pope is especially concerned with exploring the justifiability of private and public limitations on individual liberty, end-of-life medicine and public health ethics.

    In this episode you’ll discover

    • why technology advances faster than our values and why it’s a big issue in Intensive Care
    • How End of life issues in Intensive Care impact on personal liberty and personal freedom
    • Patrik and Professor Pope discuss consent of Families in Intensive Care in Canada, the USA, Australia and the United Kingdom when it comes to withdrawing or limiting treatment
    • Why a Family’s opinion in Intensive Care is far more important than you think
    • Why Health providers in the United States are very conservative
    • Why “Obama Care” in the US is not all that revolutionary for Intensive Care Patients
    • How an Intensive Care budget or insurance issues of Patients might impact on the clinical decision making process in Intensive Care
    • Why a discussion about end of life issues and/or limitation or withdrawal of treatment in Intensive Care always needs to be a value based discussion
    • What other Families in Intensive Care can learn from the Jahie McMath case in California
    • How the media can help Families in Intensive Care
    • Why there are short term facilities for brain dead Patients in the USA
    • What Families can do in other countries like Australia or the UK if their loved one has been diagnosed as brain dead
    • Why some Families want to opt-out of neurological testing for brain death and what alternatives are available
    • Why Professor Pope is optimistic that the Internet is increasing transparency in health care
    • Why conflict in Intensive Care is epidemic and what Families in Intensive Care can do about it
    • Why discussions about perceived Quality of Life need to be value based
    • Patrik and Professor Pope discuss recent cases from the UK where Patients have been “made NFR” (Not for resuscitation) without Family consent and why it’s an illegal practice

    Sincerely, your Friend
    Patrik Hutzel

    Podcast interview with Medical Futility expert and lawyer Professor Thaddeus Pope is a post from: INTENSIVE CARE HOTLINE

    The post Podcast interview with Medical Futility expert and lawyer Professor Thaddeus Pope appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/podcast-interview-professor-thaddeus-pope/feed/ 0 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/prof+pope+interview.m4a In this episode of the INTENSIVECAREHOTLINE.COM Podcast I interviewed Professor Thaddeus Pope a US based lawyer and medical futility expert! https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/prof+pope+interview.m4a In this episode of the INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com) Podcast I interviewed Professor Thaddeus Pope a US based lawyer and medical futility expert! Professor Pope is especially concerned with exploring the justifiability of private and public limitations on individual liberty, end-of-life medicine and public health ethics. (http://intensivecarehotline.com/wp-content/uploads/2014/02/11.jpg) In this episode you'll discover * why technology advances faster than our values and why it's a big issue in Intensive Care * How End of life issues in Intensive Care impact on personal liberty and personal freedom * Patrik and Professor Pope discuss consent of Families in Intensive Care in Canada, the USA, Australia and the United Kingdom when it comes to withdrawing or limiting treatment * Why a Family's opinion in Intensive Care is far more important than you think * Why Health providers in the United States are very conservative * Why "Obama Care" in the US is not all that revolutionary for Intensive Care Patients * How an Intensive Care budget or insurance issues of Patients might impact on the clinical decision making process in Intensive Care * Why a discussion about end of life issues and/or limitation or withdrawal of treatment in Intensive Care always needs to be a value based discussion * What other Families in Intensive Care can learn from the Jahie McMath case in California * How the media can help Families in Intensive Care * Why there are short term facilities for brain dead Patients in the USA * What Families can do in other countries like Australia or the UK if their loved one has been diagnosed as brain dead * Why some Families want to opt-out of neurological testing for brain death and what alternatives are available * Why Professor Pope is optimistic that the Internet is increasing transparency in health care * Why conflict in Intensive Care is epidemic and what Families in Intensive Care can do about it * Why discussions about perceived Quality of Life need to be value based * Patrik and Professor Pope discuss recent cases from the UK where Patients have been "made NFR" (Not for resuscitation) without Family consent and why it's an illegal practice Sincerely, your Friend Patrik Hutzel intensiv yes
    How long will my critically ill loved one in an induced coma for after a brain or head injury? http://intensivecarehotline.com/long-will-critically-ill-loved-one-induced-coma-brain-head-injury/ http://intensivecarehotline.com/long-will-critically-ill-loved-one-induced-coma-brain-head-injury/#comments Mon, 27 Jan 2014 20:00:16 +0000 http://intensivecarehotline.com/?p=4883 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+induced+coma+for+brain+injury.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode […]

    How long will my critically ill loved one in an induced coma for after a brain or head injury? is a post from: INTENSIVE CARE HOTLINE

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    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered the question “Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?” if you haven’t read, watched or listened to the episode you can click on it here.

    In this week’s episode of your questions answered I want to look at How long will my critically ill loved one in an induced coma for after a brain or head injury?”

    Head or brain injuries are difficult to manage from an emotional and from a clinical point of view

    Head or brain injuries are generally difficult to manage and difficult to deal with on all levels, whether it be from an emotional point of view for a Family and they also tend to be difficult to manage from a clinical perspective for the Intensive Care team.

    The reason for the issues surrounding head or brain injuries, are generally speaking that the brain and the head have a life on their own.

    In comparison, other major organs such as the heart, the lungs, the liver and the kidneys can be controlled if they stop functioning or working properly at least temporarily. Those organs can also be removed and can be replaced by donor organs. That’s not the case with the brain.

    The brain has a life on its own

    The brain on the other hand is very difficult to control, especially with severe head or brain injuries and as we all know, the brain has a life on its own. It’s not an organ such as the heart or the lungs that has a clearly and relatively easy defined purpose (heart= pump blood and lungs= breathe in and out).

    It doesn’t work that way with the brain as it is an organ that is just too complex in its very nature.

    If your critically ill loved one has been admitted to Intensive Care with a severe head or brain injury, you will most likely find that your critically ill loved one is in an induced coma and is on a breathing machine(ventilator or respirator).

    Furthermore, you might see all those coloured numbers on the screen of the bedside monitor where your critically ill loved one has been connected to. One of those numbers on the screen is most likely the intracranial pressure(pressure in the brain) that is constantly being measured.

    Elevated and raised pressures in the brain are the reason for the induced coma

    Depending on the nature and the severity of your critically ill loved one’s head or brain injury and also depending on whether there is bleeding evident or ongoing in  the brain, the pressures in the brain of your critically ill loved one are most likely to be elevated and raised. Raised and elevated brain pressures are extremely dangerous, because it can lead to irreversible brain damage due to lack of oxygen supply. If the intracranial brain pressure(pressure in the brain) is elevated and raised it needs to be managed and the pressure needs to be reduced quickly so that no further damage is done to the brain.

    Now, if your critically ill loved one wasn’t in an induced coma and ventilated, those brain pressures would be hard to manage if they were elevated and raised. Because of the induced coma, your critically ill loved one is getting intravenous sedative and opiate(pain killers) drugs such as Propofol, Midazolam, Fentanyl, Morphine or even Thiopental(a sedative generally only used for head or brain injuries). By having your critically ill loved one in an induced coma minimizes and reduces the risk that brain pressures are getting high in the first place. Imagine your loved one was “awake” and would cough, move and would be restless, chances that brain pressures would rise and cause irreversible brain damage would be extremely high.

    Therefore a calm, quiet and unconscious state, induced by a coma is the best option to control and manage the brain pressure and brain or head injury.

    Once the brain pressures are controlled and stable, that’s generally speaking the time, when your critically ill loved one can be slowly woken up out of the induced coma.

    How long for the induced coma before your loved one can be woken up?

    So the timeframe for an induced coma with severe head or brain injuries can take from a few days to a few weeks. It all depends on how stable or unstable the brain pressures are and it also depends on any other injuries that your critically ill loved one may have sustained. Some other injuries sustained such as rip fractures, HIP/ Pelvis fractures, spinal fractures may require some form of sedation as well.

    But as soon as the brain pressures are under control and normal, that would be the time for your critically ill loved one to be woken up from the induced coma.

    I hope that this episode helped and clarified your questions about the induced coma and head or brain injuries.

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    How long will my critically ill loved one in an induced coma for after a brain or head injury? is a post from: INTENSIVE CARE HOTLINE

    The post How long will my critically ill loved one in an induced coma for after a brain or head injury? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/long-will-critically-ill-loved-one-induced-coma-brain-head-injury/feed/ 0 http://youtu.be/3YAlteBJ2EE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+induced+coma+for+brain+injury.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Familie... http://youtu.be/3YAlteBJ2EE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+induced+coma+for+brain+injury.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered the question “Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?” if you haven’t read, watched or listened to the episode you can click on it here. In this week’s episode of “your questions answered” I want to look at “How long will my critically ill loved one in an induced coma for after a brain or head injury?” Head or brain injuries are difficult to manage from an emotional and from a clinical point of view Head or brain injuries are generally difficult to manage and difficult to deal with on all levels, whether it be from an emotional point of view for a Family and they also tend to be difficult to manage from a clinical perspective for the Intensive Care team. The reason for the issues surrounding head or brain injuries, are generally speaking that the brain and the head have a life on their own. In comparison, other major organs such as the heart, the lungs, the liver and the kidneys can be controlled if they stop functioning or working properly at least temporarily. Those organs can also be removed and can be replaced by donor organs. That’s not the case with the brain. The brain has a life on its own The brain on the other hand is very difficult to control, especially with severe head or brain injuries and as we all know, the brain has a life on its own. It’s not an organ such as the heart or the lungs that has a clearly and relatively easy defined purpose (heart= pump blood and lungs= breathe in and out). It doesn’t work that way with the brain as it is an organ that is just too complex in its very nature. If your critically ill loved one has been admitted to Intensive Care with a severe head or brain injury, you will most likely find that your critically ill loved one is in an induced coma and is on a breathing machine(ventilator or respirator). Furthermore, you might see all those coloured numbers on the screen of the bedside monitor where your critically ill loved one has been connected to. One of those numbers on the screen is most likely the intracranial pressure(pressure in the brain) that is constantly being measured. Elevated and raised pressures in the brain are the reason for the induced coma Depending on the nature and the severity of your critically ill loved one’s head or brain injury and also depending on whether there is bleeding evident or ongoing in  the brain, the pressures in the brain of your critically ill loved one are most likely to be elevated and raised. Raised and elevated brain pressures are extremely dangerous, because it can lead to irreversible brain damage due to lack of oxygen supply. If the intracranial brain pressure(pressure in the brain) is elevated and raised it needs to be managed and the pressure needs to be reduced quickly so that no further damage is done to the brain. Now, if your critically ill loved one wasn’t in an induced coma and ventilated, those brain pressures would be hard to manage if they were elevated and raised. Because of the induced coma, your critically ill loved one is getting intravenous sedative and opiate(pain killers) drugs such as Propofol, Midazolam, Fentanyl, Morphine or even Thiopental(a sedative generally only used for head or brain injuries). By having your critically ill loved one in an induced coma minimizes and reduces the risk that brain pressures are getting high in the first place. Imagine your loved one was “awake” and would cough, intensiv yes
    The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care http://intensivecarehotline.com/3-ways-turn-tables-favour-control-power-influence-whilst-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/3-ways-turn-tables-favour-control-power-influence-whilst-loved-one-critically-ill-intensive-care/#comments Sun, 26 Jan 2014 20:00:06 +0000 http://intensivecarehotline.com/?p=4876 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+turn+the+tables+in+your+favour%26have+control%2Cpower%26influence+whilst+your+loved+one%27s+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve […]

    The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

    The post The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “The 3 things you didn’t know that are happening behind the scenes, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence!” You can read, watch or listen to the blog by clicking on the link here.

    In this week’s blog, I want to show you another powerful tip and powerful strategy that helps you to have more control, power and influence and in this week, you will discover

    “The 3 ways on how to turn the tables in your favour and have control, power and influence whilst your loved one is critically ill in Intensive Care!”

    Fear, frustration, stress, struggle, challenge, the feeling of vulnerability, loss of control, the feeling of powerlessness and the lack of influence are all things you can resonate with if your loved one has been admitted to Intensive Care for critical illness.

    Furthermore, you feel like the Intensive Care team is talking over you and at you, but not really with you and neither are they interested in getting your view of the situation.

    Nor can or will they empathize with what you and the rest of your Family are really going through. This is hard to swallow and you can feel your world is tumbling down and you can see that other people are driving the bus and that bus is going in a direction that you have absolutely no control over…

    Not a good position to be in.

    You feel like the Intensive Care team has all the power or that’s at least your perception of the situation. The Intensive Care team has already, directly or indirectly told you that they are wielding all the power, control and influence in this situation and the Intensive Care team really treats you as a passive bystander of the situation.

    That’s how the Intensive Care team is framing the situation and if you are like 99% of Families of critically ill Patients in Intensive Care you buy into that frame of mind and you wind up having no control, no power and no influence and the Intensive Care team continues to drive the bus and they make sure that you can’t even look at the steering wheel.

    What do I mean by this? I mean that the Intensive Care team has an agenda and that agenda is driven by the things that are happening “behind the scenes” in Intensive Care. Their agenda is driven by the psychology, by the power games, by the intrigue and by the politics in an Intensive Care Unit…

    Your biggest weapon is to be vigilant and alert!

    This is particularly true if your critically ill loved one is in a critical and dire situation. This is also particularly true if the situation of your critically ill loved one is an uncertain and life threatening situation and it’s also true if your critically ill loved one might be in a situation where a long-term stay in Intensive Care is on the horizon.

    That’s when the Intensive Care team has an agenda and that’s when you need to carefully listen what the Intensive Care team is telling you and what they are not telling you. That’s the time when you and your Family need to position yourself correctly and that’s the time when you need to start asking questions. What type of questions?

    I’m glad you’ve asked.

    Now, if you are like 99% of Families of critically ill Patients in Intensive Care you won’t ask any questions, you won’t position yourself correctly and the Intensive Care team will drive their agenda forward, regardless.

    Unless you belong into that 1% bracket of Families of critically ill Patients in Intensive Care who actually do ask questions and position themselves correctly and strongly and have an agenda themselves, which actually is the best interest of your critically ill loved one.

    Those 1% of Families of critically ill Patients in Intensive Care are actually able “To turn the tables in their favour and have control, power and influence whilst their loved one is critically ill in Intensive Care!”

    How do you do that? How can you turn the tables in your favour, whilst your loved one is critically ill in Intensive Care?

    You will turn the tables in your favour whilst your loved one is critically ill in Intensive Care if you follow those 3 steps.

    Number one:

    Do your own research. Don’t be intimidated by the Intensive Care team and don’t think that just because they are doctors and nurses that they know it all. If your loved one is critically ill in Intensive Care and if you have been told that your critically ill loved one’s situation is life threatening and that your loved one might not survive their stay in Intensive Care or if the Intensive Care team is telling you that a “withdrawal of treatment” or a “limitation of treatment” is “in the best interest” of your critically ill loved one, you need to question those very assumptions of the Intensive Care team.

    Your job is to find out whether the clinical reality warrants for the Intensive Care team to suggest a “withdrawal of treatment” or whether the Intensive Care team’s positioning of your critically ill loved one’s prognosis and diagnosis is dependent on

    • Other admissions waiting for precious and scarce ICU beds
    • The financial viability of your critically ill loved one’s treatment and stay in Intensive Care(scream “good vs bad business case”)
    • The Intensive Care team has a negative mindset and doesn’t believe in the recovery of your critically ill loved one

    Some Intensive Care Units, depending on their culture(positive vs negative) are prepared “to do whatever it takes” to get your critically ill loved one on their way to recovery, whereas other ICU’s are negative and are not prepared to do “whatever it takes”.

    Your job is to find out, why the Intensive Care team is suggesting what they are suggesting and you can do that by

    Number two:

    Asking difficult, challenging and inconvenient questions, such as the ones I have hinted towards in number one.

    For example, does the Intensive Care team weigh your critically ill loved one’s stay and treatment in Intensive Care up against financial indicators and against financial viability?

    By asking whether the Intensive Care team expects their beds to be fully occupied in the next few days or weeks and if that’s the case the Intensive Care team may present your critically ill loved one’s prognosis and diagnosis in a negative light to “sell” to you and your Family that a “withdrawal of treatment” or a “limitation of treatment” is in the best interest” of your critically ill loved one and they therefore want to free up an expensive ICU bed ASAP for the next (financially more viable) admission.

    Number three:

    Don’t “suck up” to the doctors and the nurses and don’t put them on a “pedestal”. Just as I’ve mentioned earlier the Intensive Care team “frames” the situation implicitly or explicitly as if they have all the control, power and influence in this situation.

    99% of Families of critically ill Patients “buy” into that frame of mind and they therefore believe consciously or unconsciously that they have no control, power and influence.

    Turn it all around. Stop buying into that frame of mind and therefore as a first step you need to stop “sucking” up to the Intensive Care team, because that’s what 99% of Families of critically ill Patients do.

    Be in that 1% bracket of Families of critically ill Patients who have control, power and influence and I can promise you that if you stop “sucking” up to the Intensive Care team and if you do so consciously, the Intensive Care team will notice, because they are not used to it and you will find that it’ll change the dynamics in your favour immediately!

    How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

    The post The 3 ways on HOW TO TURN THE TABLES IN YOUR FAVOUR and have control, power and influence whilst your loved one is critically ill in Intensive Care appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/3-ways-turn-tables-favour-control-power-influence-whilst-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/idbnCLz-9Yg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+turn+the+tables+in+your+favour%26have+control%2Cpower%26influence+whilst+your+loved+one%27s+in+ICU.mp3 - Hi, http://youtu.be/idbnCLz-9Yg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+turn+the+tables+in+your+favour%26have+control%2Cpower%26influence+whilst+your+loved+one%27s+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve shown you “The 3 things you didn’t know that are happening behind the scenes, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence!” You can read, watch or listen to the blog by clicking on the link here. In this week’s blog, I want to show you another powerful tip and powerful strategy that helps you to have more control, power and influence and in this week, you will discover “The 3 ways on how to turn the tables in your favour and have control, power and influence whilst your loved one is critically ill in Intensive Care!" Fear, frustration, stress, struggle, challenge, the feeling of vulnerability, loss of control, the feeling of powerlessness and the lack of influence are all things you can resonate with if your loved one has been admitted to Intensive Care for critical illness. Furthermore, you feel like the Intensive Care team is talking over you and at you, but not really with you and neither are they interested in getting your view of the situation. Nor can or will they empathize with what you and the rest of your Family are really going through. This is hard to swallow and you can feel your world is tumbling down and you can see that other people are driving the bus and that bus is going in a direction that you have absolutely no control over… Not a good position to be in. You feel like the Intensive Care team has all the power or that’s at least your perception of the situation. The Intensive Care team has already, directly or indirectly told you that they are wielding all the power, control and influence in this situation and the Intensive Care team really treats you as a passive bystander of the situation. That’s how the Intensive Care team is framing the situation and if you are like 99% of Families of critically ill Patients in Intensive Care you buy into that frame of mind and you wind up having no control, no power and no influence and the Intensive Care team continues to drive the bus and they make sure that you can’t even look at the steering wheel. What do I mean by this? I mean that the Intensive Care team has an agenda and that agenda is driven by the things that are happening “behind the scenes” in Intensive Care. Their agenda is driven by the psychology, by the power games, by the intrigue and by the politics in an Intensive Care Unit… Your biggest weapon is to be vigilant and alert! This is particularly true if your critically ill loved one is in a critical and dire situation. This is also particularly true if the situation of your critically ill loved one is an uncertain and life threatening situation and it’s also true if your critically ill loved one might be in a situation where a long-term stay in Intensive Care is on the horizon. That’s when the Intensive Care team has an agenda and that’s when you need to carefully listen what the Intensive Care team is telling you and what they are not telling you. That’s the time when you and your Family need to position yourself correctly and that’s the time when you need to start asking questions. What type of questions? I’m glad you’ve asked. Now, if you are like 99% of Families of critically ill Patients in Intensive Care you won’t ask any questions, you won’t position yourself correctly and the Intensive Care team will drive their agenda forward, regardless. intensiv yes
    Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? http://intensivecarehotline.com/doctors-intensive-care-insert-tracheostomy-induced-coma/ http://intensivecarehotline.com/doctors-intensive-care-insert-tracheostomy-induced-coma/#comments Mon, 20 Jan 2014 20:00:45 +0000 http://intensivecarehotline.com/?p=4825 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Why+do+doctors+in+Intensive+Care+insert+a+Tracheostomy+after+an+induced+coma-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode […]

    Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? is a post from: INTENSIVE CARE HOTLINE

    The post Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? appeared first on INTENSIVE CARE HOTLINE.

    ]]>

    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered one of our reader’s question “What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now?” You can read, watch or listen to this question here.

    In this week’s episode of “your questions answered” I want to answer another question that our readers ask on a regular basis and the question is “Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?”

    Ventilation and the Induced Coma and what might lead to it

    If your loved one has been admitted to Intensive Care for critical illness and if your critically ill loved one has been in an induced coma for any length of time and hasn’t woken up or hasn’t come out of the induced coma as yet and is still dependent on the ventilator/ respirator you may have asked yourself what might be next? And you may have also heard the Intensive Care team making suggestions of what might be next, if your critically ill loved one hasn’t woken up from the induced coma as yet.

    Inducing your critically ill loved one into a coma in Intensive Care is often the only way to treat the underlying disease or illness that brought your loved one into Intensive Care in the first place. This usually goes hand in hand with mechanical ventilation and a breathing tube. The admission scenarios that led to your critically ill loved one coming to Intensive Care, getting induced into a coma for mechanical ventilation with a breathing tube, can range from Poly or multitrauma, brain or head injuries, to many types of surgery including Open heart surgery, Triple A repair or Aneurysm repair, Sepsis, Stroke, Seizures, Asthma, COPD, Heart Attack, lung or heart transplant, Pneumonia and the list goes on…

    Sedatives and opiates(pain medication) keeping your loved one in the induced coma are not the long-term answer and cure

    Sometimes the induced coma is necessary for a few days and as a rule of thumb, the longer your critically ill loved one stays in the induced coma, the higher the risk that your loved one is getting weaker and therefore a weaning off the ventilator may become increasingly difficult.

    The other risk that your critically ill loved one is facing when getting induced into a coma is that “waking up” out of the induced coma may sometimes be delayed and/or not “straight forward”, because during the induced coma your critically ill loved one has been heavily sedated with sedatives and opiates(pain medication) such as Propofol, Midazolam, Fentanyl or Morphine, to name but a few of the drugs.

    Here are some of the reasons why “waking up” may not be straight forward

    These sedatives and opiates are very effective when it comes to keeping your critically ill loved one in the induced coma. They are less effective and even detrimental when it comes to your critically ill loved one coming out or “waking up” from the induced coma. The more sedatives and opiates(pain medication) have been used during the induced coma and the longer your critically ill loved one is kept in the induced coma, the higher the risk that your loved one “waking up” and getting weaned off the ventilator gets delayed and more and more difficult.

    Other risk factors that delay “waking up” and weaning off the ventilator are things such as

    • Head or brain injuries
    • Polytrauma or multitrauma
    • Seizures
    • Stroke
    • Hypoxic brain injury
    • Kidney failure(if the kidneys fail, drugs accumulate in the body system and are difficult to be cleared by the kidneys)
    • Liver failure(similar to kidney failure)
    • Generally speaking, with increasing age, coming out of an induced coma gets more difficult

    A Tracheostomy might be the next step

    If in any of the scenarios mentioned above, where your critically ill loved one has been removed from the sedation and the opiates and in theory your loved one should come out of the induced coma, breathe by themselves and be taken off the ventilator and things don’t go as planned and your critically ill loved one is only waking up slowly or not at all and therefore taking your critically ill loved one off the ventilator is getting delayed and difficult, that’s usually the time when the Intensive Care team mentions that performing a Tracheostomy might be the next step.

    The reason why a Tracheostomy might be the treatment of choice and in your loved one’s best interest is that with a Tracheostomy in place, usually sedation and opiates(pain medication) can be minimized or completely removed. With the breathing tube in your critically ill loved one’s mouth, you may have already sensed that this is extremely uncomfortable and requires some sort of sedation and opiates(pain medication) in order for your critically ill loved one to tolerate the breathing tube and the ventilator.

    With a Tracheostomy in place, sedation and opiates can be either completely removed or at least minimized and breathing on a ventilator/respirator is so much easier to tolerate for your critically ill loved one.

    Now, “waking up” and weaning off the ventilator might be a much more achievable goal

    Furthermore, because your critically ill loved one has now been taken off the sedation and the opiates or at least they have been minimized, it’s so much easier for the Intensive Care team to assess your critically ill loved one whether he or she is “waking up”.

    Moreover, now that your critically ill loved one has a Tracheostomy, he or she can be taken off the ventilator and breathe via an oxygen mask or via a Tracheostomy mask without the ventilator. This usually is a gradual process, where after the Tracheostomy has been performed, your critically ill loved one can be taken off the ventilator for a few hours and then breathe with the ventilator/ respirator again. This step by step process, with the goal to gradually wean your loved one off the ventilator/ respirator is so much easier to achieve with a Tracheostomy, compared to the breathing tube in your loved one’s mouth.

    A Tracheostomy generally doesn’t cause much pain and discomfort and your loved one should be able to speak as well

    The Tracheostomy generally speaking doesn’t cause much pain and discomfort, whereas as you might have seen already, the breathing tube in your loved one’s mouth is very hard to tolerate and is just uncomfortable.

    Furthermore, especially when it comes to prolonged stays in Intensive Care and if your critically ill loved one is still at a point where he or she is still unstable and if your critically ill loved one might face breathing issues, the Tracheostomy has shown to be much more Patient friendly compared to the breathing tube through the mouth.

    Another secondary “pay-off” and advantage for your critically ill loved one is that when your loved one has time off the ventilator and is able to breathe with oxygen only, the Intensive Care team should be able to insert a “speaking valve”, where your critically ill loved one should be able to speak. Ask the Intensive Care team if that’s a possibility and keep pushing and asking for it.

    Some related articles that you also might want to check out:

     How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? is a post from: INTENSIVE CARE HOTLINE

    The post Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? appeared first on INTENSIVE CARE HOTLINE.

    ]]>
    http://intensivecarehotline.com/doctors-intensive-care-insert-tracheostomy-induced-coma/feed/ 0 http://youtu.be/d7D3kuBAMaY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Why+do+doctors+in+Intensive+Care+insert+a+Tracheostomy+after+an+induced+coma-.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , http://youtu.be/d7D3kuBAMaY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Why+do+doctors+in+Intensive+Care+insert+a+Tracheostomy+after+an+induced+coma-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered one of our reader’s question “What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now?” You can read, watch or listen to this question here. In this week’s episode of “your questions answered” I want to answer another question that our readers ask on a regular basis and the question is “Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?” Ventilation and the Induced Coma and what might lead to it If your loved one has been admitted to Intensive Care for critical illness and if your critically ill loved one has been in an induced coma for any length of time and hasn’t woken up or hasn’t come out of the induced coma as yet and is still dependent on the ventilator/ respirator you may have asked yourself what might be next? And you may have also heard the Intensive Care team making suggestions of what might be next, if your critically ill loved one hasn’t woken up from the induced coma as yet. Inducing your critically ill loved one into a coma in Intensive Care is often the only way to treat the underlying disease or illness that brought your loved one into Intensive Care in the first place. This usually goes hand in hand with mechanical ventilation and a breathing tube. The admission scenarios that led to your critically ill loved one coming to Intensive Care, getting induced into a coma for mechanical ventilation with a breathing tube (http://intensivecarehotline.com/breathing-tube-or-endotracheal-tube/), can range from Poly or multitrauma, brain or head injuries, to many types of surgery including Open heart surgery, Triple A repair or Aneurysm repair, Sepsis, Stroke, Seizures, Asthma, COPD, Heart Attack, lung or heart transplant, Pneumonia and the list goes on… Sedatives and opiates(pain medication) keeping your loved one in the induced coma are not the long-term answer and cure Sometimes the induced coma is necessary for a few days and as a rule of thumb, the longer your critically ill loved one stays in the induced coma, the higher the risk that your loved one is getting weaker and therefore a weaning off the ventilator may become increasingly difficult. The other risk that your critically ill loved one is facing when getting induced into a coma is that “waking up” out of the induced coma may sometimes be delayed and/or not “straight forward”, because during the induced coma your critically ill loved one has been heavily sedated with sedatives and opiates(pain medication) such as Propofol, Midazolam, Fentanyl or Morphine, to name but a few of the drugs. Here are some of the reasons why “waking up” may not be straight forward These sedatives and opiates are very effective when it comes to keeping your critically ill loved one in the induced coma. They are less effective and even detrimental when it comes to your critically ill loved one coming out or “waking up” from the induced coma. The more sedatives and opiates(pain medication) have been used during the induced coma and the longer your critically ill loved one is kept in the induced coma, the higher the risk that your loved one “waking up” and getting weaned off the ventilator gets delayed and more and more difficult. Other risk factors that delay “waking up” and weaning off the ventilator are things such as * Head or brain injuries intensiv yes
    The 3 things you didn’t know that are happening BEHIND THE SCENES, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence! http://intensivecarehotline.com/3-things-didnt-know-happening-behind-scenes-whilst-loved-one-critically-ill-intensive-care-must-know-want-control-power-influence/ http://intensivecarehotline.com/3-things-didnt-know-happening-behind-scenes-whilst-loved-one-critically-ill-intensive-care-must-know-want-control-power-influence/#comments Sun, 19 Jan 2014 20:00:44 +0000 http://intensivecarehotline.com/?p=4820 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Things+you+didn%27t+know+that+happen+behind+the+scenes+whilst+your+loved+one+is+critically+ill+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve […]

    The 3 things you didn’t know that are happening BEHIND THE SCENES, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence! is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “The 5 step contrarian advice for Families of critically ill Patients in Intensive Care that gives you control, power and influence whilst your loved one is critically ill in Intensive Care” You can read, watch or listen to the blog by clicking on the link here.

    In this week’s blog I want to show you “The 3 things you didn’t know that are happening behind the scenes, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence!”

    If your loved one has been admitted to Intensive Care for critical illness, chances are that you are out of your comfort zone and that you feel challenged, frustrated, vulnerable, stressed and you feel like there’s just too much happening all at once.

    Moreover, you feel like you have little or no control, power and influence, because the Intensive Care team holds all the perceived power in the situation and they most likely have already told you so, directly or indirectly. What’s even worse, they won’t tell you what’s really happening, because the situation that you, your Family and your critically ill loved one are in is a very difficult situation and the Intensive Care team really has no desire to change that situation and if anything the Intensive Care team wants to make sure that they keep you at “arms’ length” so to speak so that they can continue driving their agenda without you and especially without you and your Family having control, power and influence.

    Insights and the “behind the scenes” stuff are crucial for you having control, power and influence

    The Intensive Care team will also make sure that you and your Family don’t get any insight into the things that are happening “behind the scenes” in Intensive Care that

    • Is driving the decision making
    • Is driving the allocation of resources
    • Is driving the positioning of the Intensive Care team as it relates to your critically ill loved one’s prognosis and diagnosis

    After all there is far too much at stake for the Intensive Care team and the Hospital that goes way beyond the emotional drama that you, your Family and your critically ill loved one are going through.

    99% of Families of critically ill Patients in Intensive Care don’t have control power and influence, because they don’t know what’s happening “behind the scenes”

    Moreover, if you are like 99% of Families of critically ill Patients in Intensive Care, the Intensive Care team continues to hold all the power, control and influence in the situation, because you haven’t even thought about or considered that the decisions that are made and the positioning that the Intensive Care team displays is all dependent on the things that are happening in the background and “behind the scenes” so to speak. Those dynamics are in play from the minute you enter the Intensive Care unit and if you buy into and if you don’t question those dynamics you wind up having no control, power and influence at all…

    Unless, unless you belong in the 1% bracket of Families of critically ill Patients in Intensive Care who wind up having control, power and influence, irrespective of the situation that they and their critically ill loved one are in. And you may wonder why they have control, power and influence?

    I’m glad you’ve asked… Those Families have control, power and influence because they question the authority they are dealing with and they are courageous enough to do their own independent research(like at www.INTENSIVECAREHOTLINE.COM)  and they are not afraid to speak up, ask difficult questions and generally do the total opposite of what 99% of Families of critically ill Patients are doing.

    I therefore want to give you “The 3 things you didn’t know that are happening behind the scenes, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence!”

    NUMBER ONE:

    The Intensive Care team’s positioning of your critically ill loved one’s prognosis and diagnosis is ALWAYS dependent on whether your critically ill loved one is viewed as a “good business case” or a “bad business case”.

    Therefore, if the Intensive Care team thinks that they are not making any money if they continue treating your loved one’s critical illness, they will position your loved one’s prognosis and diagnosis accordingly.

    This is especially important for you and for your Family if your critically ill loved one is facing a long-term stay in Intensive Care or has any other type of injury or disease such as severe head injuries, polytrauma etc… This is irrespective of whether your critically ill loved one is on a government scheme or a privately insured Patient. Your job is to listen carefully and to question the Intensive Care team’s very positioning

    NUMBER TWO:

    Many Intensive Care Units are heavily involved in research activities and generally speaking a lot of money and funding goes towards research activities.

    Therefore, if your critically ill loved one falls into one of the research categories, your critically ill loved one may get preferred treatment, at least for a while, however the outcome may still be uncertain. If on the other hand, your critically ill loved one doesn’t fall in a research category, the Intensive Care team may not be interested in giving your critically ill loved one their fullest attention. Again, this is particularly important for you and for your Family to know if your critically ill loved one is in a difficult situation, where the Intensive Care team is uncertain about the outcome.

    Therefore, if your critically ill loved one doesn’t fall into a research category that the Intensive Care team might be interested in, your critically ill loved one’s prognosis and diagnosis may be positioned by the Intensive Care team that makes it easy for them to “withdraw treatment” or “limit treatment” so that they can allocate resources towards other Patients where the Intensive Care team has a higher interest in.

    NUMBER THREE:

    Generally speaking, Intensive Care beds are precious and scarce. They are expensive and they also need a fair number of staff to run(doctors and nurses).

    Many Intensive Care Units have a good idea of how many admissions are to be expected over the next few days and they always predict and keep lists of admissions updated. Therefore, if your critically ill loved one is perceived by the Intensive Care team as a difficult case and one with an uncertain outcome and therefore could potentially block a bed that would stop other scheduled admissions from coming to the Intensive Care Unit, again, the Intensive Care team might position your critically ill loved one’s prognosis and diagnosis in a more negative light and the Intensive Care team may distort the clinical facts and the clinical realities.

    This again, is particularly important for you to know if your loved one might need an ICU bed for a long time to come or if your critically ill loved one is in a life threatening and serious condition. In those situations, where the Intensive Care team knows that there are many admissions competing for a limited number of beds, they may give preference to Patients who are expected to be less sick and have a higher chance to survive, compared to Patients who are in difficult, life threatening situations with an uncertain outcome.

    It is a lot easier to then tell Families of critically ill Patients that their loved one isn’t going to survive their stay in Intensive Care and the Intensive Care team therefore may suggest to “withdraw treatment” or “limit treatment” and let your loved one die, whereas in reality if the Intensive Care team would continue treating your critically ill loved one, they may well get the results that your critically ill loved one and you desire by saving their life.

    However the Intensive Care team wants to give preference to other Patients where they don’t expect as many difficulties, where they may earn more money and they therefore tell you and your Family that your loved one’s situation is “hopeless” and the best solution for the Intensive Care team and their agenda is to let your critically ill loved one die…

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 3 things you didn’t know that are happening BEHIND THE SCENES, whilst your loved one is critically ill in Intensive Care, but you must know if you want to have control, power and influence! is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/3-things-didnt-know-happening-behind-scenes-whilst-loved-one-critically-ill-intensive-care-must-know-want-control-power-influence/feed/ 0 http://youtu.be/dbmJ3RFcGEg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Things+you+didn%27t+know+that+happen+behind+the+scenes+whilst+your+loved+one+is+critically+ill+in+ICU.mp3 - Hi, http://youtu.be/dbmJ3RFcGEg https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/Things+you+didn%27t+know+that+happen+behind+the+scenes+whilst+your+loved+one+is+critically+ill+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENS... intensiv yes
    Has Intensive Care become obsolete for long-term ventilated Adults& Children with Tracheostomy? http://intensivecarehotline.com/intensive-care-become-obsolete-long-term-ventilated-adults-children-tracheostomy/ http://intensivecarehotline.com/intensive-care-become-obsolete-long-term-ventilated-adults-children-tracheostomy/#comments Sat, 18 Jan 2014 04:22:45 +0000 http://intensivecarehotline.com/?p=5214 https://s3-ap-southeast-2.amazonaws.com/intensivecareathome.com.au/Is+Intensive+Care+obsolete+for+Long+Term+Ventilated+Patients+with+Tracheostomy-.mp3 This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive […]

    Has Intensive Care become obsolete for long-term ventilated Adults& Children with Tracheostomy? is a post from: INTENSIVE CARE HOTLINE

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    This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au

    Hi it’s Patrik Hutzel from INTENSIVECAREATHOME.COM.AU where we help long-term ventilated Adults& Children with Tracheostomy to improve their Quality of life and where we also help hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!

    In last week’s blog I was talking about The 5 things you didn’t know INTENSIVE CARE AT HOME can do for your ICU” If you want to read the article you can click on this link here http://intensivecareathome.com.au/five-things-didnt-know-intensive-care-home-can-icu/

    In this week’s blog I want to ask the question

    “Has Intensive Care become obsolete for long-term ventilated Adults& Children with Tracheostomy?”

    Having worked in Intensive Care for nearly 15 years now has given me a very different perspective about life, about life’s limitations and also about life’s possibilities, irrespective of the challenges that some people encounter within Intensive Care and I guess everybody who has worked in Intensive Care for any period of time would agree that working in Intensive Care is not for “normal people”.

    A few of those years that I worked in Intensive Care I worked in the community with long-term ventilated Adults& Children with Tracheostomy and I looked after them in their own home. The alternative for those long-term ventilated Adults& Children with Tracheostomy and their Families was a long-term stay in Intensive Care.

    Thankfully in most European countries, mainly in Germany, Austria and Switzerland the alternative to a long-term stay in Intensive Care for long-term ventilated Adults& Children with Tracheostomy is Home Care, based on successful models of Intensive Home Care nursing that provide a genuine alternative to a long-term stay in Intensive Care.

    More importantly, Intensive Care and a burdensome lengthy stay for those long-term ventilated Adults& Children with Tracheostomy has become obsolete.   

    And it’s a “no- brainer” for everybody who has seen it or worked in a home care environment with long-term ventilated Adults& Children with Tracheostomy.

    It’s a “no- brainer” for

    • Patients
    • Their Families
    • Intensive Care Units
    • Doctors
    • Nurses
    • Health Funds(Public or Private)

    Because it works and it has been proven over and over again for more than 15 years now.

    And why has it been so successful?

    Because everybody who has dealt with or looked after depressed long-term ventilated Adults& Children with Tracheostomy in Intensive Care knows that such a limiting and inhibiting environment that is Intensive Care can not provide the Quality of life and/or Quality of end of life for long-term ventilated Adults& Children with Tracheostomy.

    Therefore, Intensive Care has become obsolete for long-term ventilated Adults& Children with Tracheostomyand everybody who has worked with long-term ventilated Adults& Children with Tracheostomy in their own home knows that the improved Quality of Life for those Clients and their Families is something that enables them to

    • Blossom in their own environment
    • Gives them more control over their destiny with the right support structure
    • Enables them to look at possibilities and opportunities(i.e. go back to work, kindergarten, school, university etc…)
    • Be around their Family and loved ones

    What are your thoughts? Do you think that INTENSIVE CARE has become obsolete for long-term ventilated Adults& Children with Tracheostomy? Leave your comments on the blog below.

    If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply send me an email to patrik@intensivecareathome.com.au 

    This is Patrik Hutzel from INTENSIVECAREATHOME.COM.AU  and I’ll see you again in another update next week.

     

    Has Intensive Care become obsolete for long-term ventilated Adults& Children with Tracheostomy? is a post from: INTENSIVE CARE HOTLINE

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    What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now? http://intensivecarehotline.com/options-mother-intensive-care-ventilated-tracheostomy-three-weeks-now/ http://intensivecarehotline.com/options-mother-intensive-care-ventilated-tracheostomy-three-weeks-now/#comments Mon, 13 Jan 2014 20:00:06 +0000 http://intensivecarehotline.com/?p=4770 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/What+options+for+my+mother+in+ICU+if+she+has+been+ventilated+with+Tracheostomy+for+about+3+weeks+now.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I answered the second part of this question “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?” You can read and access this second part of the question here. If you want to read the first part of the question too, check out this link here.

    In this week’s episode of your questions answered I want to answer another of our reader’s questions and in this week Lorna from Columbus, Ohio asks “What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now?”

    Hello Patrik,

    I’m reaching out for info and help, I’m desperate for any advice you could give. Info in the US is hard to come by. My mom is currently in the ICU at a University Hospital and has been for 3 weeks. She is trached, and they are having trouble getting her off the ventilator.

    Sepsis is what sent her to the ER, at which time she was admitted and later went into respiratory failure. They’re not planning to release her yet, but I’m terrified for what the future could hold for us.

    We have a “weaning facility” here in town, where I understand she will be sent after release from ICU. In the tragic event she is unable to be weaned from the ventilator, they’re saying she will have to go to Nebraska to a long term ventilator care place!! Nebraska! I’m terrified! My mom, our family LIVES in Columbus, Ohio!!! I absolutely under no circumstances will ship my mother off to a different state where she will be a number in a bed, too sick to breathe on her own. Can you imagine how devastating that would be to someone who is already in the grips of the most awful event of their life?? I’m in DESPERATE need here! I can’t find any alternatives as of yet and I’m just sick with fear every day- I can’t even keep food down at this point. I need to know what we can do. Something else that might help is that she is on the medicare/medicaid system. I’m just sick with all of this! Please help!

    Thank you, Lorna!

    Hi Lorna,

    thank you for your email and I wish you and your Family a happy new year!

    I appreciate you reaching out for help and reaching out for help is often the first step in the right direction.

    I can understand your frustration with the system and I can understand that you and your Family are feeling like the health system is not treating you and your Family like you should be treated. It sounds to me as if the Intensive Care Unit are trying to “take the easy way out”.

    I know, it’s easier said than done, but panicking is the worst thing to do for you and for your Family and of course, for your mother as well.

    Also, three weeks in Intensive Care on a ventilator with Tracheostomy is not a particularly long time, for somebody the Intensive Care team may consider a “long-term ventilated Patient with Tracheostomy”. So putting things in perspective is very important for you and for your Family.

    Generally speaking, somebody who is considered a “long-term ventilated Patient with Tracheostomy” would not fall into that category after about 4-6 weeks in ICU.

    My first guess, without knowing much about the Intensive Care Unit that your mother is currently in, is that the Intensive Care team will be trying to send your mother out ASAP for a number of reasons and I will address those reasons later on.

    First, let’s look at the things that you can control in your situation. Often, a lot of time and energy are wasted by worrying about the things that you can’t control.

    1) You can’t control the Intensive Care team’s positioning at this stage, however you can control your positioning that will counteract the Intensive Care team’s positioning and that may buy your mother crucial time and it may increase chances for your mother to be successfully weaned off the ventilator

    2) You need to also quickly educate yourself about Intensive Care and long-term ventilation with Tracheostomy, as generally speaking there are unique challenges that go hand in hand with a stay in Intensive Care and ventilation with Tracheostomy

    As I have said, three weeks in Intensive Care is not a particularly long time, especially with ventilation and Tracheostomy and it would help if I knew how long your mother had the Tracheostomy for and how long your mother has been out of the induced coma?

    As far as the Intensive Care team’s positioning goes, it sounds to me like the Intensive Care team wants to send your mother out ASAP for a number of reasons

    • a long-term ventilated Patient with Tracheostomy can be considered as a “bed block” and the ICU therefore is unable to admit other Patients that are generally competing for scarce, precious and expensive ICU beds and staff
    •  A long term ventilated Patient with Tracheostomy may not be seen as a Patient that is financially viable for the Intensive Care Unit and that’s generally irrespective whether Patients are on a government scheme like in your case or a Private Patient, as Intensive Care Units generally make their money from shorter stays
    • Your mother may not fall into a category where the Intensive Care team has a high interest in continuing the treatment. I.e. you’ve mentioned that your mother is in a University Hospital/ICU and University Hospitals are generally speaking doing a lot of research and they therefore may prefer treating other Patients that fit some of their research criteria

    I know that some of it sounds harsh, but it’s the unfortunate reality in some ICU’s and it’s important that you have an awareness of it.

    Your job is to ask difficult and challenging questions to the Intensive Care team, because that is when you start having control, power and influence.

    Related Article: The 5 reasons why you need to be difficult and demanding when your loved one is critically ill in Intensive Care

    I furthermore have sent some reports for you that will quickly educate you on the topic of long-term ventilation with Tracheostomy in Intensive Care

    The reports I have sent for you are

    1)      “Follow this proven system to avoid the 3 most dangerous mistakes you are making but you are unaware of, if your loved one is a long-term ventilated Patient with Tracheostomy in Intensive Care”

    2) “6 answers to the 6 most frequently asked questions, if your loved one requires ongoing mechanical ventilation with Tracheostomy in INTENSIVE CARE”

    Those reports should help you as a starting point and just by learning some of the things in the reports will shift the dynamics that you will have with the Intensive Care team and you will increase your level of control, power and influence!

    Please contact me again if you need anymore help of if you have any other questions!

    Sincerely, your friend

    Patrik Hutzel

     How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now? is a post from: INTENSIVE CARE HOTLINE

    The post What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now? appeared first on INTENSIVE CARE HOTLINE.

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    http://intensivecarehotline.com/options-mother-intensive-care-ventilated-tracheostomy-three-weeks-now/feed/ 0 http://youtu.be/3WTCpAs1Fpc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/What+options+for+my+mother+in+ICU+if+she+has+been+ventilated+with+Tracheostomy+for+about+3+weeks+now.mp3 - Hi, http://youtu.be/3WTCpAs1Fpc https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/What+options+for+my+mother+in+ICU+if+she+has+been+ventilated+with+Tracheostomy+for+about+3+weeks+now.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered the second part of this question “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?” You can read and access this second part of the question here. If you want to read the first part of the question too, check out this link here. In this week’s episode of “your questions answered” I want to answer another of our reader’s questions and in this week Lorna from Columbus, Ohio asks “What are the options for my mother in Intensive Care if she has been ventilated with Tracheostomy for about three weeks now?” Hello Patrik, I'm reaching out for info and help, I'm desperate for any advice you could give. Info in the US is hard to come by. My mom is currently in the ICU at a University Hospital and has been for 3 weeks. She is trached, and they are having trouble getting her off the ventilator. Sepsis is what sent her to the ER, at which time she was admitted and later went into respiratory failure. They're not planning to release her yet, but I'm terrified for what the future could hold for us. We have a "weaning facility" here in town, where I understand she will be sent after release from ICU. In the tragic event she is unable to be weaned from the ventilator, they're saying she will have to go to Nebraska to a long term ventilator care place!! Nebraska! I'm terrified! My mom, our family LIVES in Columbus, Ohio!!! I absolutely under no circumstances will ship my mother off to a different state where she will be a number in a bed, too sick to breathe on her own. Can you imagine how devastating that would be to someone who is already in the grips of the most awful event of their life?? I'm in DESPERATE need here! I can't find any alternatives as of yet and I'm just sick with fear every day- I can't even keep food down at this point. I need to know what we can do. Something else that might help is that she is on the medicare/medicaid system. I'm just sick with all of this! Please help! Thank you, Lorna! Hi Lorna, thank you for your email and I wish you and your Family a happy new year! I appreciate you reaching out for help and reaching out for help is often the first step in the right direction. I can understand your frustration with the system and I can understand that you and your Family are feeling like the health system is not treating you and your Family like you should be treated. It sounds to me as if the Intensive Care Unit are trying to "take the easy way out". I know, it's easier said than done, but panicking is the worst thing to do for you and for your Family and of course, for your mother as well. Also, three weeks in Intensive Care on a ventilator with Tracheostomy is not a particularly long time, for somebody the Intensive Care team may consider a "long-term ventilated Patient with Tracheostomy". So putting things in perspective is very important for you and for your Family. Generally speaking, somebody who is considered a "long-term ventilated Patient with Tracheostomy" would not fall into that category after about 4-6 weeks in ICU. My first guess, without knowing much about the Intensive Care Unit that your mother is currently in, is that the Intensive Care team will be trying to send your mother out ASAP for a number of reasons and I will address those reasons later on. intensiv yes
    The 5 step contrarian advice for Families of critically ill Patients in Intensive Care that gives you control, power and influence whilst your loved one is critically ill in Intensive Care http://intensivecarehotline.com/5-step-contrarian-advice-families-critically-ill-patients-intensive-care-gives-control-power-influence-whilst-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/5-step-contrarian-advice-families-critically-ill-patients-intensive-care-gives-control-power-influence-whilst-loved-one-critically-ill-intensive-care/#comments Sun, 12 Jan 2014 20:00:20 +0000 http://intensivecarehotline.com/?p=4763 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+step+contrarian+advice+for+Families+of+critical+Pts+in+ICU+to+give+you+control%2Cpower%26influence.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I’ve […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “How to quickly become resilient whilst your loved one is critically ill in Intensive Care” You can read, watch or listen to last week’s update here.

    In this week’s blog I want to show you “The 5 step contrarian advice for Families of critically ill Patients in Intensive Care that gives you control, power and influence whilst your loved one is critically ill in Intensive Care”

    If your loved one has been admitted to Intensive Care for critical illness, chances are that you feel out of your comfort zone. Furthermore, you feel challenged, frustrated, stressed, vulnerable and you feel like there is very little or no support for Families of critically ill Patients in Intensive Care.

    You most likely also feel like everything is in the hands of the Intensive Care team and you may feel like the Intensive Care team is not really telling you about what’s been happening, what’s about to happen and where your critically ill loved one is really up to. If the Intensive Care team is telling you and giving you updates they do so in their medical jargon and in their medical language that leaves you wondering of what they have really said. Not a good position to be in.

    You may have also wondered and worried how you, your Family and your critically ill loved one are going to get through this challenging and often “once in a lifetime” situation, as there tends to be so little support, education and information for Families of critically ill Patients available and if you are given information, the Intensive Care team doesn’t really speak your language… and they tend to speak their own medical language and jargon…

    Now, if you are like most Families of critically ill Patients you just leave it there and you suffer silently and you hope for the best and you keep wondering…

    Hope is NOT a strategy that works in the face of adversity
    As hope generally is not a strategy that gets you results, you and your Family are like the majority of Families of critically ill Patients in Intensive Care and you continue to have no control, no power and no influence during this time where your loved one is critically ill in Intensive Care…

    Meanwhile the Intensive Care team continues to run the show, continues to use their medical jargon and they continue to keep you “half informed” so to speak…

    Again, not a good position to be in.
    And if you are like 99% of Families of critically ill Patients in Intensive Care you give in to the perceived power dynamics in Intensive Care, where you perceive that the Intensive Care team holds all the power, control and influence.

    Unless you have started to think about getting informed and doing your own research so to speak. That is a great starting point and it puts your very close to those 1% of Families of critically ill Patients in Intensive Care who have control, power and influence, because those Families have realised that in order to get the best possible result and best possible outcome for your critically ill loved one you need to do something about it, get informed, do your own research and also challenge the perceived dynamics in Intensive Care, that the Intensive Care team has well scripted for you so that you don’t have any control, power and influence…

    Taking a few counterintuitive steps might help…
    More importantly, in order to be in that 1% bracket of Families of critically ill Patients in Intensive Care who have control, power and influence, you and your Family need to take a very counterintuitive step and you need to look at what 99% of the Families of critically ill Patients in Intensive Care do, which is being passive, and you need to do the total opposite of what they do. And the reality and the matter of the fact is that if you and your Family do the total opposite of what 99% of Families of critically ill Patients do, you will find yourself in a position where you will have control, power and influence and you will be getting results!

    As I have said, you and your Family need to go against the grain and therefore I give you “The 5 step contrarian advice for Families of critically ill Patients in Intensive Care that gives you control, power and influence whilst your loved one is critically ill in Intensive Care”

    1.       Look at what other Families(in fact 99% of Families) in Intensive Care are doing and do the complete opposite

    Given that you have come to this website and that you have started to look for information about critical illness and Intensive Care, shows that you are taking the first steps to becoming informed and you are probably fed up with the Intensive Care team not speaking your language and that they only use their medical jargon that you can’t understand.

    As I have mentioned before 99% of Families of critically ill Patients in Intensive Care suffer silently and they don’t question the dynamics and the power games the Intensive Care team plays and those Families of critically ill Patients in Intensive Care continue to have no power, no control and no influence!

    You are well on your way in turning the perceived power dynamics around and you are well on your way to have control, power and influence if you continue educating yourself here at www.INTENSIVECAREHOTLINE.com and if you start challenging the status quo.

    2.       Keep asking the right and sometimes difficult questions

    Most Families of critically ill Patients in Intensive Care are so overwhelmed, challenged, frustrated, vulnerable, powerless, stressed and without real support that their emotions have taken over and they can’t think clearly. Those Families are therefore not in a position to simply ask the right questions. The reality is that if you simply ask the right questions you get the right answers.

    If you are like 99% of Families of critically ill Patients in Intensive Care you are overwhelmed by the perceived power of the Intensive Care team. If you however belong in that 1% bracket of Families of critically ill Patients in Intensive Care who have control, power and influence you will ask the right questions and you are not afraid to ask difficult questions and some of those questions are questions that will take the Intensive Care team off balance so to speak. And so they should, because if you’re not asking the right and difficult questions you stand very little chance in gaining any control, power or influence. But you can only ask the right questions if you are taking a “crash course” so to speak about Intensive Care and if you quickly learn at www.INTENSIVECAREHOTLINE.com what’s important and what questions you need to ask.

    3.       Continue to be difficult and demanding

    If you are like 99% of Families of critically ill Patients in Intensive Care, you are nice, friendly and you think that the Intensive Care team holds all the power. And that’s right. They have all the power if you are friendly and nice and if you continue to think that the Intensive Care team “knows it all”.

    If you are however in that 1% bracket of Families of critically ill Patients in Intensive Care who have control, power and influence you probably have also realised that when it comes to critical illness, long-term stays in Intensive Care or even difficult decisions about end of life, “withdrawal of treatment”, “withdrawal of life support” and “Futility of treatment” you probably have gauged by now that the “moving parts behind the scenes” of an Intensive Care Unit, the politics, the intrigue and the psychology play a major part in how the Intensive Care team positions themselves and your critically ill loved one’s prognosis and diagnosis.

    Therefore your positioning starts with asking the right questions and don’t be shy to ask difficult questions.

    Related Articles:

    4.       Change your body language

    Most Families of critically ill Patients walk around in Intensive Care with their arms crossed, their head down and a slumped and poor body language. As research has shown more than 60% of what we say is in our body language and only 7% or so is in the words we use.

    Walking around with poor body language and poor posture is telling the Intensive Care team and your critically ill loved one that you have no control, power and influence.

    If you want to belong in that 1% bracket of Families of critically ill Patients in Intensive Care who have control, power and influence, you need to show that to the world by changing your physique and by changing your body language. Walk upright, back straight, shoulders out, hold your head high, uncross your arms and show the world that you are ready to face this challenge. You will send clear signals and a strong non-verbal message to the Intensive Care team and your critically ill loved one as well if you have strong posture and good body language.

    5.       Change your thinking

    99% of Families of critically ill Patients in Intensive Care have no control, power and influence because their brain has been hijacked by negative emotions. And because of that they think that they can’t have control, power and influence. In fact 99% of Families of critically ill Patients in Intensive Care are so overwhelmed by their negative emotions that they can’t think clearly, let alone let any positive thoughts in.

    Your job, if you want to belong in the 1% bracket of Families who have control, power and influence whilst your loved one is critically ill in Intensive Care is to recognize that your brain has been hijacked by negative emotions.

    Your next step then is to change your thoughts from negative to positive and get your brain hijacked by positive emotions.

    By you showing positivity, optimism and the belief that you can have control, power and influence, you will send an extremely strong signal to the Intensive Care team and to your critically ill lived one.

    Do just that and you have already made a big impact on yourself, your Family, the Intensive Care team and your critically ill loved one, because they can feel your positive vibes and they can feel your positive energy.

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 5 step contrarian advice for Families of critically ill Patients in Intensive Care that gives you control, power and influence whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/5-step-contrarian-advice-families-critically-ill-patients-intensive-care-gives-control-power-influence-whilst-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/9BgCj5CWaI8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+step+contrarian+advice+for+Families+of+critical+Pts+in+ICU+to+give+you+control%2Cpower%26influence.mp3 - Hi, http://youtu.be/9BgCj5CWaI8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+step+contrarian+advice+for+Families+of+critical+Pts+in+ICU+to+give+you+control%2Cpower%26influence.mp3 Hi, it’s Patrik Hutzel from INTENSI... intensiv yes
    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2) http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-2/ http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-2/#comments Mon, 06 Jan 2014 20:00:53 +0000 http://intensivecarehotline.com/?p=4686 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+2.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode […]

    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2) is a post from: INTENSIVE CARE HOTLINE

    The post How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2) appeared first on INTENSIVE CARE HOTLINE.

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I answered the first part of this question “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)” You can read and access this first part of the question here.

    In this week’s episode of your questions answered I want to go deeper and while I explained last week why Family meetings are held in the first place, this week I want to give you some solid tips and strategies how you need to prepare yourself and your Family for such meetings and I explain how you can be prepared, mentally strong and well positioned, so that you have control, power and influence in those meetings!

    So, last week I showed you that Family meetings are generally held if there’s bad news. On top of delivering “bad news” there are perceived power dynamics in motion that you need to be highly aware of, because generally speaking 99% of Families of critically ill Patients in Intensive Care think that the Intensive Care team holds all the power. And they will hold all of the power if you let them hold all the power and if you

    • Don’t ask the right questions
    • If you’re not well prepared
    • If you’re mentally not strong
    • If you’re mentally not well positioned

    So now you’re questions is, how can you be well prepared, mentally strong and mentally well positioned?

    And that’s a fantastic question to ask, because 99% of Families of critically ill Patients don’t think that they can be well prepared, mentally strong and mentally well positioned when going into a Family meeting with the Intensive Care team.

    Why Family meetings with the Intensive Care team can be a “FARCE”

    As I have mentioned last week, Family meetings can be almost a “Farce”, as the only purpose from the Intensive Care team’s point of view is to deliver bad news and to drive their agenda. And they often don’t get any resistance because 99% of Families of critically ill Patients don’t ask the right questions, they’re not well prepared, they’re mentally not strong and they’re mentally not well positioned.

    The reason for that is generally that Families of critically ill Patients are so overwhelmed, paralysed, frustrated, out of control, powerless with no influence, they feel vulnerable and anxious and they clearly have far too much respect for the Intensive Care team and their perceived power.

    The Intensive Care team’s power is only perceived and that’s where you need to hone in

    And here it comes. The Intensive Care team’s power is only that. It’s only perceived. That’s it. You perceive them to be powerful and therefore it’s all in your head.

    Change your perception as a starting point and stop perceiving the Intensive Care team as powerful and start thinking of yourself as powerful! Do just that as a starting point and you’ll find yourself on solid ground when going into a Family meeting!

    Furthermore, whenever you and your Family are in a Family meeting you need to be highly vigilant about the positioning of the Intensive Care team and you need to be extremely vigilant about what they say, what they don’t say, how they say it and the meaning behind it. Your job is to read between the lines so to speak.

    Whenever the Intensive Care team uses the term “In the best interest for your critically ill loved one” your alarm bells need to start ringing

    As I have said before, the Intensive Care team tends to deliver bad news in Family meetings and delivering those bad news may or may not be “in the best interest” of your critically ill loved one and as I have said before, it’s often based on what is happening “behind the scenes”.

    Especially if the Intensive Care team is telling you that your critically ill loved one is not going to survive their stay in Intensive Care or if they talk about “poor outcomes”, “poor prognosis” and other negative things such as “Futility of treatment”, “withdrawal of life support”,  or if they are talking about “withdrawal of treatment”.

    Related Article: The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    And my favourite one is that whenever the Intensive Care team is using the terms above that it’s “in the best interest” for your critically ill loved one.

    Whatever the Intensive Care team frames or perceives to be “in the best interest” for your critically ill loved one is often highly questionable. Not only should anybody be very careful about judging what is “in the best interest” of anyone, because the reality is that nobody should make any judgements about anybody’s “best interest” if they don’t know them personally. Life is far too complex and neither the Intensive Care team nor anybody else should make any judgments about “what is in the best interest” for your critically ill loved one or for anybody else.

    The Intensive Care team has scripted the Family meetings well in advance…

    In more than 15 years Intensive Care nursing in three different countries I have seen it all. And if you and your Family are not well prepared, mentally strong and well positioned, the Intensive Care team will keep the upper hand and they will walk all over you and your critically ill loved one during those Family meetings that the Intensive Care team has scripted well in advance and well before you arrived in those meetings.

    Your emotions have taken over and the Intensive Care team knows that and takes full advantage of the situation

    One thing that I have found is that Families of critically ill Patients in Intensive Care, during those Family meetings are so overwhelmed by their emotions that they can’t think clearly and the Intensive Care team knows that and they generally take full advantage of it, by pressing their agenda forward, which is based on what’s happening “behind the scenes” such as

    • the politics
    • the intrigue
    • the psychology of an Intensive Care Unit
    • and the competing interests amongst many other things
    • such as how many admissions are awaiting admission to Intensive Care
    • whether the Intensive Care team thinks that your critically ill loved one is a “good business case” in terms of financial viability(irrespective of whether your loved one is under a government scheme or a Private Patient)
    • whether the Intensive Care team perceives your critically ill loved one to be a good research study case and the list could go on

    I think now that I have shed more light on the dynamics in Intensive Care, you also understand that if you’re not well prepared, not mentally strong and not well positioned that you will stand no chance in those Family meetings!

    The interests of the Intensive Care team will dominate the agenda of the Family meeting if you’re not well prepared and if you’re not asking the right questions…

    Therefore you need to have a quick and succinct education about how you can be mentally prepared, mentally strong and well positioned if you are going into a Family meeting with the Intensive Care team! Because if you’re like most Families of critically ill Patients in Intensive Care and if you’re not educating yourself, you will also get the results of the majority of Families of critically ill Patients in Intensive Care, which will leave you powerless, with no control and with no influence and you, your Family and your critically ill loved one are subject to the Intensive Care team’s agenda and the Intensive Care team, especially when it comes to their positioning about your critically ill loved one’s prognosis and diagnosis, that will drive the Intensive Care team’s agenda forward, irrespective of the clinical realities and the Intensive Care team will distort the reality depending on their interests and agenda!

    Listen, Family meetings are usually happening when it comes to difficult and lengthy stays in Intensive Care and/or end-of life situations, where the Intensive Care team often wants to “withdraw life support”, “withdraw treatment” and if you don’t know how to counteract their positioning you and your critically ill loved one are doomed.

    The Intensive Care team is often positioning your critically ill loved one’s prognosis and diagnosis in a negative light without giving your critically ill loved one a fair chance to recover. They give you the “doom and gloom” and you have no idea what’s really happening….

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn QUICKLY how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care!

    Your FREE “INSTANT IMPACT” Report will help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2) is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-2/feed/ 0 http://youtu.be/PRTHNGEMYJY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+2.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill P... http://youtu.be/PRTHNGEMYJY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+2.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” and in last week’s episode I answered the first part of this question “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)” You can read and access this first part of the question here. In this week’s episode of “your questions answered” I want to go deeper and while I explained last week why Family meetings are held in the first place, this week I want to give you some solid tips and strategies how you need to prepare yourself and your Family for such meetings and I explain how you can be prepared, mentally strong and well positioned, so that you have control, power and influence in those meetings! So, last week (http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-1/) I showed you that Family meetings are generally held if there’s bad news. On top of delivering “bad news” there are perceived power dynamics in motion that you need to be highly aware of, because generally speaking 99% of Families of critically ill Patients in Intensive Care think that the Intensive Care team holds all the power. And they will hold all of the power if you let them hold all the power and if you * Don’t ask the right questions * If you’re not well prepared * If you’re mentally not strong * If you’re mentally not well positioned So now you’re questions is, how can you be well prepared, mentally strong and mentally well positioned? And that’s a fantastic question to ask, because 99% of Families of critically ill Patients don’t think that they can be well prepared, mentally strong and mentally well positioned when going into a Family meeting with the Intensive Care team. Why Family meetings with the Intensive Care team can be a "FARCE" As I have mentioned last week (http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-1/), Family meetings can be almost a “Farce”, as the only purpose from the Intensive Care team’s point of view is to deliver bad news and to drive their agenda. And they often don’t get any resistance because 99% of Families of critically ill Patients don’t ask the right questions, they’re not well prepared, they’re mentally not strong and they’re mentally not well positioned. The reason for that is generally that Families of critically ill Patients are so overwhelmed, paralysed, frustrated, out of control, powerless with no influence, they feel vulnerable and anxious and they clearly have far too much respect for the Intensive Care team and their perceived power. The Intensive Care team’s power is only perceived and that’s where you need to hone in And here it comes. The Intensive Care team’s power is only that. It’s only perceived. That’s it. You perceive them to be powerful and therefore it’s all in your head. Change your perception as a starting point and stop perceiving the Intensive Care team as powerful and start thinking of yourself as powerful! Do just that as a starting point and you’ll find yourself on solid ground when going into a Family meeting! Furthermore, whenever you and your Family are in a Family meeting you need to be highly vigilant about the positioning of the Intensive Care team and you need to be extremely vigilant about what they say, what they don’t say, how they say it and the meaning behind it. Your job is to read between the lines so to speak. intensiv yes
    How to quickly become resilient whilst your loved one is critically ill in Intensive Care http://intensivecarehotline.com/quickly-become-resilient-whilst-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/quickly-become-resilient-whilst-loved-one-critically-ill-intensive-care/#comments Sun, 05 Jan 2014 20:00:47 +0000 http://intensivecarehotline.com/?p=4682 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+quickly+become+resilient+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I’ve shown you “The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is)” You can read, watch or listen to last week’s update here.

    In this week’s blog I want to show you “How to quickly become resilient whilst your loved one is critically ill in Intensive Care”

    One of the biggest challenges if your loved one is critically ill in Intensive Care is to manage yourself and your Family.

    Very few experiences and events in life are as challenging and stressful as having a loved one critically ill in Intensive Care. It’s not only that you, your Family and your critically ill loved one feel challenged, stressed, frustrated, scared, overwhelmed, vulnerable and out of your comfort zone. It’s also that fear and the feeling that you have no control, no power and no influence about the event whatsoever. It is therefore that you feel that you are absolutely powerless, that you have no control and that you are unable to influence any decision making whatsoever. Not a good position to be in…

    Especially since the Intensive Care team has all the perceived power and is driving the bus…
    What often helps in a situation like this is to be resilient, because after all, you and your Family don’t know how long your loved one is remaining critically ill in Intensive Care and you don’t really know what’s around the corner so to speak.

    Furthermore, it helps to be resilient if your critically ill loved one remains in Intensive Care for a long time or even worse, if your loved one is dying in Intensive Care.
    Both situations, if your loved one remains critically ill in Intensive Care for longer than expected and if your loved one is approaching their end of life in Intensive Care are screaming for you to become resilient quickly. It’s one of those core skills that you must have in those challenging, frustrating and stressful situations.

    Support for Families of critically ill Patients in Intensive Care is hard to come by…

    The unfortunate reality is that support for Families of critically ill Patients in Intensive Care is literally non- existent!
    Hospitals and Intensive Care Units tend to be so focused on the clinical things at hand and also on driving their agenda that they totally forget that it’s not only the Patients who suffer, but it’s the Families who suffer the most, because Families are at a loss of what to do and they are at a loss of what support is available to them, if any.

    Therefore, your job is to become resilient quickly during this stressful and challenging time, whilst your loved one is critically ill in Intensive Care, hands down!
    And how exactly do you become resilient quickly during this stressful and challenging time?

    You see, one of the biggest challenges that I have seen in more than 15 years Intensive Care nursing experience in three different countries is that Families of critically ill Patients are so overwhelmed and paralysed by having a loved one critically ill in Intensive Care that they often don’t know right from wrong, they don’t know left from right and they are just simply at a loss of what to do. They are literally often running around like headless chickens…

    Don’t get “stuck” in fear and frustration

    Therefore, you and your Family need to have somebody who has walked in your shoes, show you what you need to do and how you can quickly become resilient, so that you have control, power and influence.
    You see the Intensive Care team has built some resilience when dealing with critically ill Patients and their Families, because they have done it for a long time and they know how they can exercise power, control and influence over you.

    And you may have already had a feeling or an impression of what that means and looks like for you and for your Family. The Intensive Care team is running the show and that feels and seems especially frustrating for you and for your Family if you don’t know what’s happening and if you don’t know what the next few days or even the next few hours have in stall for you, for your Family and for your critically ill loved one!
    The Intensive Care team may have been very vague and they may not have been very good at communicating with you and with your Family about the exact things that are happening…

    Part of what the Intensive Care team is doing is your own fault…

    But what if I told you that part of that you don’t really understand of what’s happening and part of why the Intensive Care team isn’t properly communicating with you is your own fault?

    What if I told you that part of why you feel powerless, with no control and without influence is your own fault?
    You see in situations where one of your loved Family members is critically ill in Intensive Care, nobody generally is guiding you in the right direction and it’s therefore crucial that you take matters in your own hands and one of the crucial skills that you need to learn is to become resilient quickly!
    Because let’s face it, if you are resilient nothing else matters really. It’s one of those golden skills and it’s one of those golden nuggets to have!

    If you and if your Family are resilient, the Intensive Care team will notice and I bet your positive energy and your positive vibes will translate to your critically ill loved one as well! If you are resilient, it is much easier for you to have control, power and influence!

    Part of becoming resilient quickly is to change your thinking and to change your body language!

    Now if you have a loved one critically ill in Intensive Care, part of the issue that you and your Family are out of your comfort zone, challenged, frustrated and overwhelmed is that your brain has been hijacked by negative thinking, by fear, by frustration and by overwhelm! It is therefore that you can’t think clearly and it’s therefore easy for other people to run the show. And because your brain has been hijacked by fear, frustration, overwhelm and panic, it is therefore that you think you can’t have control, power and influence…

    Learning the skills that put you in control of the situation

    But the reality is that you can have control, power and influence if you are becoming resilient quickly as a starting point.
    By becoming resilient quickly you need to change your thinking, you need to change your belief system and you need to change the dynamics between you and the Intensive Care team, because that skill will put you in charge of the situation!

    And once you’ve achieved that, that’s when things start changing for you and for your Family. Once you’ve achieved that, that’s when you start having control, power and influence!

    Resilience is inevitable and non-optional!

    Look, if your loved one is critically ill in Intensive Care and if he or she may be in Intensive Care for a long time to come or has been in Intensive Care for a long time already or if your critically ill loved one is dying in Intensive Care, resilience is inevitable and it’s not-optional.
    So changing your thinking from the hijacked state of fear, overwhelm, frustration, panic and challenge to a state where you know that you can have control, power and influence is the starting point. And that goes hand in hand with your body language.

    If your brain isn’t working properly and has been hijacked by fear, frustration, panic and overwhelm, chances are that your body language will show that as well. You may not walk straight and your body posture is poor. You may have your arms crossed most of the time, because you’re not ready to face reality as it is. Your body language wants to keep the negative things away and is close. But if you want to become resilient quickly, you need to change all of that!

    Change your thinking to a positive state of mind

    First let’s start with your thinking. Now that you know that your brain has been hijacked by negative thoughts and now that you know that it impacts negatively on your body language, now it’s time that you change it, because if you don’t, the reality is that it’s easy for the Intensive Care team to continue driving their agenda.
    Especially, if your critically ill loved one is in a situation where you and your Family have no idea what is about to come or where the future is uncertain, you need to have control, power and influence! Furthermore, as I mentioned, in those uncertain and volatile situations, you and your Family need to counteract the Intensive Care team’s positioning.

    What the Intensive Care team is telling you is ALWAYS based on what’s happening “behind the scenes”

    Listen, if your loved one is a long-term Patient in Intensive Care or is very unstable and/or critical or if the Intensive Care team has told you that your critically ill loved one is dying, you have no idea whether that’s true or not. The Intensive Care team’s positioning is always based on the “moving parts” of an Intensive Care Unit and their positioning is always based on what’s happening “behind the scenes” in Intensive Care and more often than not their positioning is something you need to counteract with your positioning.

    And you’d be very good at that if you and your Family are resilient and if your brain isn’t hijacked by negative thoughts triggered by fear, frustration and vulnerability. You are also resilient if your body language shows that resilience and positivity. Have an open posture, don’t cross your arms and show the Intensive Care team that you are ready to face this challenge!

    How can you become resilient quickly and how can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW  by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn QUICKLY how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care!

    Your FREE ‘INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below!
    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!
    Make sure you also check out our “your questions answered” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!
    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    How to quickly become resilient whilst your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/quickly-become-resilient-whilst-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/eCr6Bqpw7tk https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+quickly+become+resilient+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 - Hi, http://youtu.be/eCr6Bqpw7tk https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+quickly+become+resilient+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLI... intensiv yes
    The 5 things you didn’t know INTENSIVE CARE AT HOME can do for your ICU http://intensivecarehotline.com/5-things-didnt-know-intensive-care-home-can-icu/ http://intensivecarehotline.com/5-things-didnt-know-intensive-care-home-can-icu/#comments Fri, 03 Jan 2014 04:14:03 +0000 http://intensivecarehotline.com/?p=5211 https://s3-ap-southeast-2.amazonaws.com/intensivecareathome.com.au/The+five+things+you+didn%27t+know+INTENSIVE+CARE+AT+HOME+can+do+for+your+ICU.mp3 This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive […]

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    This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au

    Hi it’s Patrik Hutzel from INTENSIVECAREATHOME.com.au where we help long-term ventilated Adults& Children with Tracheostomy to improve their Quality of life and where we also help hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!

    In last week’s blog I was talking about Calls for changes in end of life care” as current practices in end-of-life care require major change to ensure more Australians experience “better” deaths, according to a panel of medical, ethical and legal experts. I also highlighted how INTENSIVE CARE AT HOME can ensure that people experience “better deaths” and choice of places where they want to die. If you want to read the article you can click on this link here http://intensivecareathome.com.au/calls-changes-end-life-care/

    In this week’s blog I want to give you ”The 5 things you didn’t know INTENSIVE CARE AT HOME can do for your ICU”

    Everybody who has worked in Intensive Care for a period of time, as well as long-term ventilated Adults or Children with Tracheostomy and their Families would agree that being a long-term ventilated Adult or Child with Tracheostomy in Intensive Care is a challenging and frustrating situation for all parties involved.

    The frustration and challenge of either being a Patient or a Family member in such a difficult situation is massive and I have seen Intensive Care teams getting frustrated as well, if they don’t see light at the end of the tunnel, when looking after long-term ventilated Adults or Children with Tracheostomy who have been in Intensive Care for long periods of time.

    If you have been following this blog for a while you would also know that INTENSIVE CARE AT HOME has a solution to offer that is both, Patient and Family friendly and also offers a solution that is creating benefits for Intensive Care Units.

    More importantly, there are “5 things you didn’t know INTENSIVE CARE AT HOME can do for your ICU”

     1.       Boost morale of your Intensive Care staff because everybody wins

    Whenever there are long-term ventilated Adults or Children with Tracheostomy in Intensive Care, there generally comes a time when everybody in the ICU gets frustrated and “fed up” dealing with the Patient and their Families, because there is only so much an Intensive Care Unit can offer to a long-term ventilated Adult or Child with Tracheostomy. By offering a Patient& Family friendly and Intensive Care Unit friendly solution and by taking a long-term ventilated Adult or Child with Tracheostomy home, everybody wins and all parties involved generally agree that taking a long term ventilated Adult or Child with Tracheostomy home is the right thing and the only thing to do. By doing that you will also have your Intensive Care staff looking after more acutely unwell Patients who are in real need of an Intensive Care bed and everybody is generally happy. Patients, Families and the Intensive Care staff.

    2.       Make your Hospital and your Intensive Care Unit look good and stand out from the crowd

    Very few Hospitals and very few Intensive Care Units in Australia so far offer tailor made solutions for long-term ventilated Adults& Children with Tracheostomy. Again, by freeing up an expensive and scarce ICU bed, you can admit more acutely unwell Patients and you can focus on reallocating your precious resources towards more acutely unwell Patients. Again, everybody wins and you can make your Hospital and your Intensive Care Unit look really good and you can stand out from the crowd!

    3.       Help your Intensive Care Unit to be more flexible with your bed management

    Depending on how many beds you have in your Intensive Care Unit, especially during busy periods, a long-term ventilated Adult or Child with Tracheostomy can not only block a bed and take up precious resources that could be used for more acutely unwell Patients. I have also seen that some Intensive Care Units end up cancelling surgery or delay admissions from other areas, because a long-term ventilated Adult or Child with Tracheostomy keeps blocking a bed. By having an empty bed available, you are just so much more flexible in managing your beds in your Intensive Care Unit and also meet the four hour target for your admissions from ED.

    4.       Be seen as innovative and as a leader in the field

    As INTENSIVE CARE AT HOME is a relatively new concept in Australia, your Intensive Care Unit would be seen as a leader in the marketplace and as somebody who is embracing and driving change needed. Furthermore, you would also be a driver of real innovation in an area where previously people thought that Home Care is not an option, however successful models of Intensive Home Care for long-term ventilated Adults& Children with Tracheostomy in Europe and the US have shown for more than 15 years now that change in Australian Intensive Care Unit is more than overdue.

    5.       Home Care for long-term ventilated Adults& Children with Tracheostomy can give your budget a boost

    Whether your Intensive Care Unit is Public, Private, for- profit or not-for-profit, the bottom line is the same. A bed in Intensive Care is very expensive and by going to a home care based model for long-term ventilated Adult or Child with Tracheostomy will give you a more cost effective option compared to an expensive long-term stay in Intensive Care.

    What are your thoughts? Can you think of any other things that INTENSIVE CARE AT HOME can do for your ICU? Leave your comments on the blog.

    If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply reply to this email.

    This is Patrik Hutzel from www.intensivecareathome.com.au  and I’ll see you again in another update next week.

    The 5 things you didn’t know INTENSIVE CARE AT HOME can do for your ICU is a post from: INTENSIVE CARE HOTLINE

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    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1) http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-1/ http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-1/#comments Mon, 30 Dec 2013 20:00:11 +0000 http://intensivecarehotline.com/?p=4591 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+1.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of your questions answered and in last week’s episode I answered one of our reader’s question, whose 25 year old wife has been in Intensive Care for more than a month and the Intensive Care team wanted to stop treatment and take her off the ventilator. You can read this question here.

    This week’s episode of “your questions answered” is the first part of “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?”. In this week I want to explain why it comes to Family meetings in the first place and why they are generally being held. In the second part I explain how you can be prepared, mentally strong and well positioned, so that you have control, power and influence in those meetings!

    This is an extremely important episode, because if I have found one thing over the many years working in Intensive Care, it’s that Families of critically ill Patients in Intensive Care are totally unprepared when it comes to Family meetings with the Intensive Care team.

    Ok, here you are. Your loved one has been admitted to Intensive Care for critical illness.

    Why are Family meetings necessary?

    The Intensive Care team has given you a quick heads up and informed you briefly about your critically ill loved one’s condition, however you and your Family haven’t quite worked out how serious the condition of your critically ill loved one really is.

    You know that the Intensive Care team is busy in trying to save your critically ill loved one’s life and that’s all you can sort of gauge at the moment, with a lot of activity going on in your critically ill loved one’s bedspace.

    As a rule of thumb please keep in mind, that as long as the Intensive Care team is giving you regular updates at the bedside of your critically ill loved one and they keep doing that regularly and you feel like things are going well, they probably are. Things are probably going well. You should also be able to gauge from people’s body language and other subtle cues on how things are tracking.

    Again, as a rule of thumb, if the Intensive Care team is calling you for a “Family meeting” and they want you to “formally” discuss things away from your critically ill loved one’s bedspace, it’s extremely important that you have an idea of not only what to expect, more importantly you and your Family need to be prepared, mentally strong and well positioned, before going into the Family meeting with the Intensive Care team. 

    Generally speaking, Family meetings in Intensive Care tend to have very specific dynamics and if you are unaware of those dynamics- and most Families of critically ill Patients are unaware of those dynamics- you will have no control, no power and no influence, because the Intensive Care team has positioned themselves before they are going into the Family meeting. The Intensive Care team generally knows what to say and how to say it and they generally also know how “normal” or “conventional” Families of critically ill Patients respond. And here I refer to Families of critically ill Patients who have no control, no power and no influence, because they don’t believe that they can have control, power and influence and they also haven’t done their own research.

    On top of that, there is the situation that you are totally out of your comfort zone, you are stressed, you feel extremely vulnerable, you haven’t slept or eaten properly, you are scared and you are just overwhelmed by everything that’s been happening.

    99% of Families of critically ill Patients in Intensive Care are totally unprepared when dealing with the Intensive Care team

    This is generally not a good position to be in. The fears, the frustrations, the overwhelm, the struggle, the stress and the fact that you know little or certainly not enough to go into a Family meeting with the Intensive Care team is not a good starting point.

    And the Intensive Care team knows that. They know that 99% of Families come unprepared and have no clue of what to expect. Therefore, it’s easy for the Intensive Care team to drive their agenda.

    Again, if it has come to the point where the Intensive Care team wants to have a Family meeting about your critically ill loved one’s situation, it’s generally not good news, because good news can be communicated straight away at the bedside.

    Family meetings set perceived dynamics in motion that you need to be aware of and that you need to counteract

    A Family meeting is more of a “Formality” and it sets a different tone from the start. It also sets some perceived dynamics in motion from the start and the perception often is that the Intensive Care team holds all the power. And that perception often goes both ways. Families of critically ill Patients consciously or unconsciously think that they have no or very little control, power and influence and the Intensive Care team more consciously than subconsciously thinks that they hold all the power, control and influence.

    That is the case and holds true in 99% of all cases.

    Unless you belong to the 1% of Families who actually do their own research, who learn about the politics, the intrigue and the psychology at play in a busy, stressful and volatile environment that is Intensive Care.

    Your biggest challenge in a Family meeting is to be prepared, to be mentally strong and to be well positioned, when it comes to Family meetings in Intensive Care. Because the reality is if you’re not, the Intensive Care team will get away with their agenda and they may walk all over you and your critically ill loved one, with so many other competing interests going on in Intensive Care.

    You might say, “Patrik, how can I be prepared in such a situation? I have no idea what’s going on and surely the Intensive Care team is here to help us and do the best they can.”

    Family meetings are often hidden “sales” meetings for bad news…

    Well, let me tell you this. When it comes to Family meetings in Intensive Care, your critically ill loved one is in difficulties. Generally Family meetings in Intensive Care serve two purposes

    1)      To give you bad news

    2)      To tell you that “the Intensive Care team is doing their best” however, despite “doing their best”, it’s still not enough and the outcome for your critically ill loved one maybe a negative one

    To put it differently, Family meetings are often hidden “sales” meetings between the Intensive Care team and you and your Family so that you accept the Intensive Care team’s positioning and agenda.

    In more than 15 years Intensive Care nursing experience in three different countries, I have however learned that the Intensive Care team’s positioning and agenda is heavily influenced by the moving parts, by the politics, by the intrigue and by the Psychology at play in an Intensive Care Unit. If you don’t know and more importantly, if you don’t learn about the moving parts, the politics, the intrigue and the Psychology in Intensive Care, you’ll wind up having no power, no control and no influence, which can be detrimental to your critically ill loved one’s situation.

    There are a couple of scenarios that are generally discussed during a Family meeting in Intensive Care

    1)      Your loved one is very unstable and very critically ill and therefore the Intensive Care team thinks that further treatment might be “futile”. Therefore the Intensive Care team thinks that it’s “in the best interest” of your critically ill loved one to “withdraw treatment” and let nature take its course and let your critically ill loved one die.

    In this example, the Intensive Care team may not be interested in investing more time, energy and resources to get your critically ill loved one on their way to recovery and they’re not even prepared to do so. In this example you may not be told the whole truth and you and your Family are kept in the dark about other treatment options such as a long-term stay in Intensive Care, that might inevitably take a long time and might take up time, energy and resources, but might also save your critically ill loved one’s life.

    In essence the Intensive Care team is keeping you in the dark about treatment options and they position your critically ill loved one’s treatment as “Futile” and as “not in the best interest” of your critically ill loved one. Your critically ill loved one may be dependent on life support and the Intensive Care team suggests that by taking away the life support such as ventilation, ECMO, Balloon pump etc… that nature will take its course and your critically ill loved one will die. What they haven’t told you is that by continuing treatment, your critically ill loved one may survive and may recover, however the Intensive Care team has no interest in doing so for a number of reasons that I will explain later.

    2)      Your loved is in a very critical condition and again, the Intensive Care team may tell you that your critically ill loved one is about to approach their end of life and die. And if the clinical facts are real and the evidence is clear, that could well be the case.

    But again, the Intensive Care team may be very blunt and may suggest that if you and your Family are prepared that they can stop life support in the next few hours and let your loved one die. For many Families this may come as a surprise and because generally speaking they are so overwhelmed, stressed and paralysed by fear that they almost agree to anything the Intensive Care team suggests.

    There are many situations however where you and your Family need more time before you will let your loved one go. Maybe you are waiting for an important Family member to come in from overseas or from interstate, before you let your loved one die. Maybe you want to have certain spiritual, cultural and/or religious needs met before your loved one may pass away. Whatever is important for you, for your Family and for your critically ill loved one, you should be telling the Intensive Care team and you should be persistent and determined to have those wishes fulfilled.

    Often, the Intensive Care team doesn’t know what’s best for your critically ill loved one

    You see, I have seen so many Families in Intensive Care being so overwhelmed by the experience that they take for face value whatever the Intensive Care team suggests to them. Families of critically ill Patients often think that the Intensive Care team must know what’s best for my critically ill loved, whereas in reality, nothing could be further from the truth.

    Those Families also wind up realising down the line, that they would have wanted more time with their loved one before saying good bye. You see, end of life situations, are “once in a lifetime” situations and you need to make sure that you have peace of mind, irrespective of what the Intensive Care team is telling you, because the Intensive Care team has an agenda and they tend to drive that agenda relentlessly.

    In next week’s your questions answered episode, I will continue with part two of “How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?”

    Today, I’ve given you some reasons why Family meetings in Intensive Care are held and next week I will dive into the strategies of how you can be prepared, be mentally strong and be well positioned when it comes to Family meetings in Intensive Care with the Intensive Care team. Next week you will walk away with some solid strategies that help you to be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team!

    In the meantime check out our other FREE resources such as our blog and the “your questions answered” section

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    Related Article:

    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2)

    How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1) is a post from: INTENSIVE CARE HOTLINE

    The post How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1) appeared first on INTENSIVE CARE HOTLINE.

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    http://intensivecarehotline.com/can-prepared-mentally-strong-well-positioned-family-meeting-intensive-care-teampart-1/feed/ 0 http://youtu.be/b23XoSQCv_o https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+1.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill P... http://youtu.be/b23XoSQCv_o https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Family+meetings+1.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://www.intensivecarehotline.com/) , where we instantly improve th... intensiv yes
    The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is) http://intensivecarehotline.com/3-things-need-anticipate-loved-one-critically-ill-intensive-careand-think/ http://intensivecarehotline.com/3-things-need-anticipate-loved-one-critically-ill-intensive-careand-think/#comments Sun, 29 Dec 2013 20:00:55 +0000 http://intensivecarehotline.com/?p=4585 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/3+things+you+need+to+anticipate+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I gave you “The 3 ways on how to ALWAYS be one step ahead of the Intensive Care team, if your loved one is critically ill in Intensive Care”. You can read, watch or listen to last week’s update here.

    In this week’s blog I want to give you “The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is)”

    If your loved one is critically ill in Intensive Care, it’s generally very hard for Family members to know and anticipate what lies ahead and to know what’s around the corner. And how would you know anyway? Critical Illness and Intensive Care tends to be a volatile and challenging environment for Families and their critically ill Family members.

    Furthermore, given the very nature of having a loved one critically ill in Intensive Care, you and your Family feel vulnerable, challenged, stressed, outside of your comfort zone, overwhelmed and anxious. Most of all you generally have no idea of what to anticipate, as Intensive Care is just a very different ball game altogether and out of all places, it’s the last place you want to spend time in.

    By now you will have a feel that the Intensive Care team is running the show…

    By now, you would probably have a taste and a feel that the Intensive Care team is running the show and you would know by now that influence, control and power is nothing that will come easily to you, in an environment that is controlled by the Intensive Care team and where they are driving the bus, so to speak.

    Because at this stage, you are so far outside of your comfort zone and overwhelmed by having a loved one critically ill in Intensive Care that you most likely haven’t slept and eaten properly. You feel exhausted, tired and because you’re also having a Family to look after, you’re close to a nervous breakdown and generally speaking there just isn’t enough support and help for Families of critically ill Patients in Intensive Care and they are generally left on their own.

    In order for you to deal effectively with the challenges of having a loved one critically ill in Intensive Care and also in order for you to have control, power and influence whilst your loved one is critically ill in Intensive Care I want to give you “The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is)”.

    Don’t be paralysed by the perceived power of the Intensive Care team

    Listen, in more than 15 years Intensive Care nursing experience in three different countries, I have seen many Families of critically ill Patients being paralysed by fear and frustration. Families also tend to be paralysed by the perceived power of the Intensive Care team.

    I have seen most Families of critically ill Patients in Intensive Care being unable to position themselves correctly against the perceived power of the Intensive Care team, in situations where clearly, their critically ill loved one would have needed them most. If Families are unable to position themselves correctly, it leads to an imbalance in the dynamics between the Intensive Care team and Families of critically ill Patients, generally with the Intensive Care team holding all the perceived power. That of course is only true if you are like 99% of Families of critically ill Patients, who don’t know what to do and they most often follow the Intensive Care team blindly.

    Related Article: The 5 reasons why you should not trust the Intensive Care team blindly if your loved one is critically ill in Intensive Care

     In order for you to hold more power, more control and more influence and counteract the perceived power of the Intensive Care team I now want to dive into “The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is)”.

    1.       Anticipate that the Intensive Care team is not interested in getting you involved in any decision making

    There are a few things that you need to know and understand if your loved one is critically ill in Intensive Care. The things that matter most in a situation like this, is often not your critically ill loved one’s diagnosis and prognosis. It’s certainly part of how the Intensive Care team positions themselves, however what’s more important and generally is hidden away from you at any cost are the moving parts within an Intensive Care Unit. The politics, the intrigue and the power dynamics that happen behind the scenes, have more often than not a huge and massive impact on the positioning of the Intensive Care team as it relates to your critically ill loved one’s prognosis and diagnosis.

    If, for example, your loved one is a long-term Patient in Intensive Care and your critically ill loved one is making slow progress and the Intensive Care team anticipates a long recovery, you and your Family might get told that “a withdrawal of treatment” or a “withdrawal of life support” might be in the “best interest” of your critically ill loved one.

    What you of course wouldn’t know, unless somebody told you, is that the Intensive Care team anticipates competing interests with the allocation of expensive and precious resources, whether it be beds, staff and/or equipment.

    Many Patients competing for an Intensive Care bed could be one reason why the Intensive Care team is telling you about the “poor prognosis” of your critically ill loved one. Furthermore, if the Intensive Care team thinks that your critically ill loved one’s case would either be too expensive to treat or if they think that they aren’t going to make enough money by treating your critically ill loved one, you and your Family get told that “a withdrawal of treatment” is “in the best interest” of your critically ill loved one.

    2.       Anticipate that if you and if your Family are not positioned correctly and that if you haven’t done your own research, you will stand no chance against the Intensive Care team’s positioning

    Your positioning, your mental strength, your willpower and the extent to which you have done your own research are your biggest guns in the battle so to speak.

    A lot is possible in Intensive Care especially with modern medicine, however if your loved one is battling a critical illness that might take a long time to recover from or if your loved one is at the brink of dying in Intensive Care, you need to have pretty big guns in order to be positioned well and have the mental strength to not only challenge the Intensive Care team and their positioning, but to also get what you want and what is in the best interest of your critically ill loved one!

    The Intensive Care team doesn’t always do what’s in the best interest of your critically ill loved one! They always do what’s in the best interest of driving their agenda forward!

    Doing your own research here at INTENSIVECAREHOTLINE.COM is one of the best things you can do, because here we give you the “behind the scenes insight” about Intensive Care that’s raw and real and we tell you the things that the Intensive Care team doesn’t want you to know. We take away the curtains and let you look into the politics, the intrigue and the dynamics that invariably lead to the Intensive Care team’s positioning and that may well have a big impact on your critically ill loved one’s destiny.

    3.       Most Intensive Care Units have Consultants and Physicians who do research about Intensive Care medicine. Anticipate that if your critically ill loved one is fighting for their life and/or is a long-term Patient in Intensive Care and is therefore perceived as a difficult and challenging case who’s taking up plenty of resources, your critically ill loved one’s treatment may well interfere and compete with the research interests of some Consultants and Physicians. Therefore, it might be in the best interest of the Intensive Care Unit, to allocate resources to other Patients who might fit the research thesis/ criteria of the Consultants and Physicians. The allocation of resources is therefore often based on research interests and not on clinical needs.

    Your job is to be highly, highly vigilant about the things that the Intensive Care team is telling you and not telling you! Your job is to read between the lines. Your job is also to question, because if you don’t question, you will never have any power, control or influence!

    Intensive Care is an Industry with many people having massive business interests. It’s therefore that Families of critically ill Patients often don’t see the bigger picture and the moving parts of an Intensive Care Unit remain hidden for them.

    Again, with so many competing interests and with so much research in Intensive Care going on, you simply don’t know what you don’t know!

    In more than 15 years Intensive Care nursing experience in three different countries I have seen it all and I have had more than plenty of insight into the dynamics, the intrigue and the politics to have learned and understood the games that the Intensive Care teams are playing to have it “their way”.

    Families of critically ill Patients in Intensive Care tend to be so overwhelmed, stressed, frightened and intimidated by the whole experience that it’s easy for the Intensive Care team to drive their agenda forward! And 99% of Families of critically ill Patients don’t question, which is the biggest challenge and the single biggest reason why Families of critically ill Patients have no power, control and no influence!

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care and how can you be in control of the situation?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where I answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 3 things you need to anticipate if your loved one is critically ill in Intensive Care(and it’s not what you think it is) is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/3-things-need-anticipate-loved-one-critically-ill-intensive-careand-think/feed/ 0 http://youtu.be/l0icltl4XM8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/3+things+you+need+to+anticipate+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 - Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE. http://youtu.be/l0icltl4XM8 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/3+things+you+need+to+anticipate+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.C... intensiv yes
    My 25 year old wife has been in ICU for one month with Tracheostomy and is still in an induced coma http://intensivecarehotline.com/25-year-old-wife-icu-one-month-tracheostomy-still-induced-coma/ http://intensivecarehotline.com/25-year-old-wife-icu-one-month-tracheostomy-still-induced-coma/#comments Mon, 23 Dec 2013 21:00:55 +0000 http://intensivecarehotline.com/?p=4520 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/My+25+year+old+wife+has+been+in+ICU+for+1+month+with+Tracheostomy+and+is+still+in+an+induced+coma.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained “The 5 things you need to know if your critically ill loved one is in Intensive Care with a severe head injury or a traumatic brain injury”. You can read, listen or watch the update here.

    In this week’s episode of “your questions answered” I want to answer one of our reader’s questions Michael from Seattle, USA.

    Hi Patrik,

    “My 25 year old wife has been in Intensive Care for one month now with Tracheostomy and she is still in an induced coma. The Intensive Care team wants to take her off the ventilator and they say that she may die. I’m at a loss and I don’t know what to do. Can you help me and give me some advice?”

    My wife has been in ICU with a Tracheostomy for the last month and the Doctors have said she has brain damage. What I want to know is how long will they keep her on ventilation for, as at the moment she cannot breathe by herself and they are not taking her off the machine as yet. Do you know how long she will be on the ventilator for and will it be a permanent thing? She also has little brain activity which is keeping her alive and she also has Lupus as a pre-existing condition.

    Prior to her ICU admission she had a chest infection and felt unwell for a few days and then she had a fit/seizures which lasted for four hours before she got admitted into Intensive Care. The Intensive Care team is now saying that she has a hypoxic brain injury and that’s why they want to stop ventilating her. Legally is there a certain time that she can be on ventilation before they just turn it off and let her go?

    Is there any way we can get her to another Hospital in the condition she is in at the minute and have her treated there?

    Hi Michael, 

    thank you for your question.

    I’m very sorry to hear that your 25 year old wife is in Intensive Care with a Tracheostomy. It sounds like she has been through a lot, especially with seizures, brain damage, Tracheostomy and the Lupus.

    There are a number of things you and your Family have to consider before the Intensive Care team may suggest to take your wife off the ventilator.

    The issues you should consider are

    • would a prolonged stay and treatment in Intensive Care increase your wife’s chances of survival and recovery?
    • If a prolonged stay in Intensive Care is increasing the chances of survival, what would your wife’s Quality of Life be?
    • If your wife has brain damage, has this been confirmed with CT scans and/or an MRI or with a Neurologist(The Intensive Care team are not the experts for brain damage)
    • If brain damage has been confirmed, is it reversible? I.e. how severe is her brain damage?
    • Does your wife have any other premedical health conditions besides the Lupus that may impede on her recovery?
    • Do you think the Intensive Care team is reasonable in their outlook or do you think they are negative in their outlook?
    • What is your gut feeling and how do you think your wife is dealing with her current difficult situation? Do you think she can beat the odds?
    • Before the Intensive Care team is taking your wife off the ventilator, there should be a weaning process that your wife should be going through- find a related article here Tracheostomy and weaning off the ventilator in Intensive Care, how long can it take?” 
    • Also, if the Intensive Care team wants to take your wife off the ventilator and is taking the risk that she may die, they need to clearly discuss this with you and your Family, explaining the risks associated with removing her ventilation. Also if the Intensive Care team intentionally takes her off the ventilator and expects her to die, they again need to clearly follow their end of life/ withdrawal of treatment policies and those policies often suggest that they need to have Family approval before they take her off the ventilator. Don’t be shy or hesitant to ask for those policies

    Also, find a related article here “The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    • Also, you need to ask whether the Intensive Care team wants to free up their ICU bed, because they have other admissions awaiting an ICU bed. If that’s the case the Intensive Care team often “sells” to the Family that a “withdrawal of treatment” is “in the best interest” for your loved one, whereas in reality, a “withdrawal of treatment” is in the best interest of the Intensive Care Unit as they can admit a new Patient once your loved one has died
    • You also need to ask if the Intensive Care team wants to stop treatment because they think that your wife’s treatment might not be financially viable for the ICU. Again, if the Intensive Care team thinks that other cases awaiting Intensive Care admission might be a better revenue stream than they may “sell” to you and your Family that a “withdrawal of treatment” is “in the best interest” for your loved one, whereas in reality, a “withdrawal of treatment” is in the best interest of the Intensive Care Unit
    • A transfer to another Hospital could well be an option, and many critically ill Patients can get transferred in a Critical condition
    • In some countries, mainly USA, Australia, Germany, Austria and Switzerland there are Intensive Home Care services for long-term ventilated Adults& Children with Tracheostomy available, therefore you may want to consider Intensive home care, maybe even end of life homecare or weaning off the ventilator at Home? A lot more is possible at home than most people think there is. Find more information at www.intensivecareathome.com.au

     I hope that helps and please let me know if you have any more questions. We have also more reports available such as “The 5 things you need to know if the medical team in Intensive Care wants to limit treatment, wants to withdraw treatment or wants to issue an NFR(not for resuscitation) order for your critically ill loved one in Intensive Care”

    Here is a link to a related article as well that will help you in your situation

     How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com just like Micheal did, with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    My 25 year old wife has been in ICU for one month with Tracheostomy and is still in an induced coma is a post from: INTENSIVE CARE HOTLINE

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    The 3 ways on how to ALWAYS be one step ahead of the Intensive Care team, if your loved one is critically ill in ICU http://intensivecarehotline.com/3-ways-always-one-step-ahead-intensive-care-team-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/3-ways-always-one-step-ahead-intensive-care-team-loved-one-critically-ill-intensive-care/#comments Sun, 22 Dec 2013 21:00:32 +0000 http://intensivecarehotline.com/?p=4516 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/How+to+ALWAYS+be+1+step+ahead+of+the+ICU+team%2C+if+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I gave away The 5 things you didn’t know you needed doing whilst your loved one is critically ill in Intensive Care!” You can read, watch or listen to last week’s update here.

    In this week’s blog I want to give you “The 3 ways on how to ALWAYS be one step ahead of the Intensive Care team, if your loved one is critically ill in Intensive Care”

    If one of your loved Family members has been admitted to Intensive Care with critical illness, you would have found by now that the Intensive Care team is running the show. Given the situation you, your Family and your critically ill loved one are in, you feel stressed, challenged, overwhelmed, anxious, out of your comfort zone, you feel vulnerable and you have no idea what lies ahead.

    Worst of all, the Intensive Care team is driving the bus and you feel like you have no control, power and influence during this stressful and challenging situation! More often than not, the Intensive Care team is talking over you and at you, rather than entering into a real dialogue and discussion. The situation you are finding yourself in is anything but comforting.

    Furthermore, the Intensive Care team is talking “Intensive Care language” that you often don’t understand and they often don’t make the effort to explain things to you in simple and plain language. It’s all part of the ball game and if you don’t know what to do and how to position your self, the Intensive Care team holds all the power and is controlling the situation.

    What an awful situation to be in. Not only is one of your loved Family members critically ill in Intensive Care, the worst feeling is probably that you’re at the mercy of the Intensive Care team. That is if you follow conventional wisdom and if you do what 99% of Families of critically ill Patients in Intensive Care do.

    Wouldn’t it be good to have control, power and influence whilst your loved one is critically ill in Intensive Care? Wouldn’t it even be better if you were ALWAYS one step ahead of the Intensive Care team whilst your loved one is critically ill in Intensive Care?

    You might say, “Patrik, don’t be stupid, there’s no way I can always be one step ahead of the Intensive Care team. They have all the power, knowledge and control”.

    Well, know this. I have worked in Intensive Care for more than 15 years in three different countries and I have seen it all. I have seen the games the Intensive Care teams are playing to keep Families of critically ill Patients at arms’ length. I have seen Intensive Care teams “selling” to Patients and their Families “that a withdrawal of treatment” is in “the best interest” of your critically ill loved one, because he or she wouldn’t have any quality of life anyway”. As if anyone besides you and your Family knows what’s “best” or in the “best interest” of your critically ill loved one.

    • Little do those Families know that the Intensive Care team thinks that the ongoing treatment of your critically ill loved one is not seen as something financially viable or is seen as too expensive.
    • Little do those Families know that the Intensive Care team is desperately needing empty beds to accommodate new admissions.
    • Little do those Families know that the treating Consultant/ Physician of the Intensive Care team has no interest in continuing treatment, because their loved one’s case and treatment is not of any interest for the Consultant’s/ Physician’s latest research thesis.

    So, put your preconceived notions about Intensive Care aside and come with me into the world where I show you “The 3 steps on how to ALWAYS be one step ahead of the Intensive Care team, if your loved one is critically ill in Intensive Care”.

    1.       Don’t buy into the “conventional wisdom” of 99% of Families of critically ill Patients in Intensive Care who believe that they have no power, no control and no influence. Your job as a starting point is to know and believe that you can have control, power and influence and therefore position yourself accordingly.

     Listen, most people out there, when they see a Doctor or a Nurse in Intensive Care think that they “must be smart” and “they must be so accomplished”. That’s because society has doctors and nurses allowed to think and act that way. Doctors and nurses are only humans and make mistakes too.

    Therefore, especially in this day and age where the Internet gives you access to tons of good information that opens up “insider” knowledge previously not accessible to common people like you and me, you can get yourself in a strong position by accessing that information and applying it to your situation. The believe that you can have control, power and influence will get you one step ahead, because the Intensive care team doesn’t expect you to act that way, because most Families of critically ill Patients feel intimidated. Act confident and act as if you have control, power and influence and you will see the dynamics shift in your favour!

    2.       99% of Families of critically ill Patients in Intensive Care think that with the specialized knowledge the Intensive Care team has that they are unable to match their expertise and they therefore don’t question!

    Know this: You don’t need to have the clinical expertise of the Intensive Care team and you don’t need to know the details of your critically ill loved one’s diagnosis. What you need to know however and what get’s you one step ahead is to know about the moving parts in Intensive Care and what’s happening “behind the scenes” so to speak. What’s happening “behind the scenes” has often a much bigger impact on how the Intensive Care team positions themselves and how they position your critically ill loved one’s prognosis and diagnosis, especially if it’s a negative prognosis and diagnosis!

    3.       Especially in very difficult situations where the Intensive Care team suggests to “withdraw treatment” or if your critically ill loved one is a long-term Patient in Intensive Care, you need to have maximum control, power and influence, because otherwise the Intensive Care team will press on with their agenda and they will walk all over you, if you’re not one step ahead!

    “Withdrawal of treatment” and/or “withdrawal of life support” are highly emotionally charged situations and very rarely is there consensus between the Intensive Care team and Families. Furthermore, another highly emotionally charged situation that Families and critically ill Patients find themselves in is if their loved one is a long-term Patient in Intensive Care(often ventilator dependent with Tracheostomy).

    So, you may wonder how you can be one step ahead of the Intensive Care team in those emotionally highly charged situation, where they hold all the perceived power?

    As I mentioned before, in order to be one step ahead you need to ask the right questions and they are often not clinical questions. They are questions that relate to the moving parts in an Intensive Care Unit and those moving parts are invisible for you and your Family in most cases. Decisions that the Intensive Care team is making are often based on what’s happening behind the scenes and they happen to have a major impact on how the Intensive Care team positions themselves and your critically ill loved one’s prognosis and diagnosis.

    How do you get all that insider knowledge in a short period of time and how do you know what things influence the Intensive Care team’s positioning about my critically ill loved one’s diagnosis and prognosis?

    More importantly, how can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial “behind the scenes” insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section where we answer your questions or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     Related articles:

    ·         The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    ·         Follow this proven 5 step process on how to be in control and influential if your loved one is a long-term Patient in Intensive Care or is facing treatment limitations in Intensive Care

     

     

    The 3 ways on how to ALWAYS be one step ahead of the Intensive Care team, if your loved one is critically ill in ICU is a post from: INTENSIVE CARE HOTLINE

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    The 5 things you need to know if your critically ill loved one is in Intensive Care with a severe head injury or a traumatic brain injury http://intensivecarehotline.com/5-things-need-know-critically-ill-loved-one-intensive-care-severe-head-injury-traumatic-brain-injury/ http://intensivecarehotline.com/5-things-need-know-critically-ill-loved-one-intensive-care-severe-head-injury-traumatic-brain-injury/#comments Mon, 16 Dec 2013 21:00:25 +0000 http://intensivecarehotline.com/?p=4443 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/5+things+you+must+know+if+your+loved+one+is+in+Intensive+Care+with+a+severe+head+or+brain+injury.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode […]

    The 5 things you need to know if your critically ill loved one is in Intensive Care with a severe head injury or a traumatic brain injury is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained “How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed?” You can read, listen or watch the update here.

    In this week’s episode of your questions answered I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question and the topic that I want to shed some light on this week is “The 5 things you need to know if your critically ill loved one is in Intensive Care with a severe head injury or a traumatic brain injury”

    One of the very hot topics for Families of critically ill Patients in Intensive Care is head injuries and/or traumatic brain injuries.

    If your loved one has been admitted to Intensive Care with severe head injuries or a traumatic brain injury after a motor vehicle accident, after a severe fall or after a fight etc… chances are that you are out of your comfort zone, that you feel vulnerable, shocked, frightened, scared and that you and your Family are looking for answers for the many questions that are running through your mind.

    Not only are you seeking for answers, you are also looking at your critically ill loved one in the condition that he or she is in and you’re wondering whether he or she will survive and/or will ever be the same.

    The Intensive Care team is probably busy trying to stabilise your critically ill loved one’s condition and they may or may not have hinted towards a prognosis of your critically ill loved one’s head or brain injury.

    After more than 15 years Intensive Care nursing experience in three different countries, there’s generally nothing harder to predict than the outcome of a severe head or brain injury.

    Therefore, it’s very important that you know and understand that there are very few hard and fast rules when it comes to the long-term prognosis of your critically ill loved one if he or she sustained a nasty head or brain injury. The brain or head generally has a life on its own and it’s the only organ that can’t be controlled. Unlike the heart, lungs, liver or kidneys that can be at least temporarily controlled when they’re not functioning properly, the brain can’t be controlled unfortunately.

    It’s therefore also very important that you know and understand the particulars of head and brain injuries, because they are very different from many other admission scenarios in Intensive Care.

    Let’s therefore look at “The 5 things you need to know if your critically ill loved one is in Intensive Care with a severe head injury or a traumatic brain injury”

    1.       Brain and/or head injuries need time(many weeks or months) to recover and therefore patience is one of your and your critically ill loved one’s biggest assets

    As I have mentioned before, head and brain injuries are very rarely straightforward. They therefore require an enormous amount of patience, diligence and stamina.  I have seen many brain and head injuries in Intensive Care that stayed for many weeks and many months in Intensive Care to not only survive but also thrive after rehabilitation.

    I have got a relative who was in Intensive Care for a severe head injury and had ongoing rehabilitation and he didn’t fully recover, but he’s certainly able to have a good Quality of Life and enjoy life with his Family. It took a long time to get him there, however the alternative would have been to stop treatment in the early stages of his ICU admission, which thankfully was never even spoken about.

    2.       The first few days after admission to Intensive Care are crucial and critical for the recovery and survival of your critically ill loved one

    Again, head and brain injuries are nasty in its nature and they often go hand in hand with increased pressure in the brain. Increased brain pressure also requires close monitoring and management.

    Therefore your critically ill loved one is in an induced coma and requires ventilation.

    High and elevated intracranial brain pressures(pressure in the brain) are not uncommon and the higher and more sustained the pressure in the brain gets, the bigger the chance that the brain may be irreversibly damaged due to lack of oxygen supply.

    Related article: What is the prognosis after my critically ill loved one’s brain has not had sufficient oxygen supply(hypoxic brain injury)?

    Having said that, the first few days and weeks are not only critical and crucial for the survival of your critically ill loved one, they are also crucial in terms of how the Intensive Care team views your critically ill loved one’s prognosis and diagnosis.

    What do I mean by that?

    The Intensive Care team doesn’t only weigh up the clinical facts, they may also position your critically ill loved one’s diagnosis and prognosis in a very negative light and they may well paint a “doom and gloom” picture.  They do this to not give you false hope and they also do it to protect their professional reputation. After all, if things go wrong and they told that they wouldn’t, you may hold them accountable and sue them.

    But there are other dynamics at play that you need to be highly vigilant and highly aware about!

    Let’s say that the Intensive Care Unit doesn’t believe in the recovery and rehabilitation of your critically ill loved one, they may suggest to you that “withdrawal of treatment” maybe in the best interest of your critically ill loved one.  The Intensive Care may also not want to invest the time and other resources that it would take to go through a lengthy and difficult Intensive Care stay. The Intensive Care team, therefore again, might talk about “Futility of treatment”

    Related Article:  The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    I have worked in some Intensive Care Units that did “whatever it took” to get a head injury out of Intensive Care alive and I worked in other Intensive Care Units that had a very negative culture and outlook and they therefore are very quick to withdraw treatment so to speak. They have “sold” the Family on the hopelessness of the situation and they then let their loved one die.

    3.       You and your Family need to listen to your gut feeling and you need to know how your critically ill loved one deals with adversity

    This is probably one of your biggest weapons so to speak.

    • Irrespective of all the doom and gloom and the negativity that the Intensive Care team may project about your critically ill loved one’s recovery, you need to carefully listen to your gut, because your gut never lies
    • How do you and the rest of your Family think that the very person in the Intensive Care bed that you dearly love will fare?
    • Take the clinical facts out of the equation for a moment. Do you and your Family think that your critically ill loved one can beat the odds?
    • Do you and the rest of your Family think that it is you who knows your critically ill loved one best or do you think it’s the Intensive Care team who knows your critically ill loved one best?
    • I have seen many critically ill Patients in Intensive Care over the years and in many situations the Intensive Care team was ready to “withdraw treatment” and let the Patient die and the Family wanted to continue treatment, because they BELIEVED in the recovery, in the strength and the SURVIVAL of their critically ill loved one and so treatment was continued with generally a favourable outcome, because it’s you and your Family who know your critically ill loved one best and it’s not the Intensive Care team…

    4.       Many Intensive Care Units simply don’t want to invest the time, energy and resources that it takes to get a severe head or brain injury Patient through a sometimes long Intensive Care stay. They often also lack the positive outlook that it takes and they have a limited mindset

    A bed in Intensive Care is a very scarce, expensive and valuable resource, generally designated to only very sick and critically ill Patients. One day in Intensive Care tends to cost $ 4,000- $ 5,000.

    The reality is that money, time or energy should not be part of the equation when it comes to saving lives.

    I have worked in some Intensive Care Units that have an abundant mindset and they simply did “whatever it took” to get a head or brain injury Patient back on the road to recovery. I remember one gentleman who was in ICU for nearly 6 months after he sustained a severe head injury and he was very sick and “half dead” at one stage, but we never gave up and he eventually recovered and left ICU, to only come back six months later to say thank you and that he couldn’t remember a single thing, but that he wanted to thank us and he was back to living a normal life.

    Other Intensive Care Units with a negative culture and a limited mindset, tend to “throw in the towel” much earlier by “selling” to Families of critically ill Patients a “hopeless” situation that would warrant a “withdrawal of treatment” or a “withdrawal of life support” and they also tell you that it’s “in the best interest” of your critically ill loved one. The only people who should know and decide about “what’s in the best interest” of a person who’s incapable of making their own decisions, is their Family and nobody else.

    5.       Many Intensive Care Units don’t want you to get involved in the decision making process about your critically ill loved one’s treatment and therapy, because the Intensive Care team wants to keep the power for themselves as there are too many wheels in motion that you simply don’t know about

    Look, after more than 15 years Intensive Care Nursing in three different countries I had plenty of time to learn the dynamics in Intensive Care inside out. They are often always the same. The Intensive Care team doesn’t want to get you involved in the decision making process and they want to keep all the power for themselves.

    The wheels that are in motion that you generally don’t know about are things like the financial viability of your critically ill loved one’s admission to Intensive Care and generally speaking a long-term stay in Intensive Care for a severe head injury is often not classified or viewed as something “financially viable”. Therefore, “withdrawing treatment” might be the preferred option for the Intensive Care team, given the financial viability around your critically ill loved one’s admission.

    Furthermore, you also need to be aware that if your critically ill loved would occupy an Intensive Care bed for a prolonged period, that other admissions wouldn’t be able to be admitted and miss out on a Critical Care bed.

    The reality is that the Intensive Care team doesn’t want you to have any control, power and influence and their only goal is to press their agenda.

    You therefore need to make sure that you maximise your level of control, power and influence, whilst your loved one is critically ill in Intensive Care

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

     Related Article

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    The 5 things you didn’t know you need doing whilst your loved one is critically ill in Intensive Care! http://intensivecarehotline.com/5-things-didnt-know-need-whilst-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/5-things-didnt-know-need-whilst-loved-one-critically-ill-intensive-care/#comments Sun, 15 Dec 2013 21:00:52 +0000 http://intensivecarehotline.com/?p=4422 ) https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+things+you+didn%27t+know+you+need+doing+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I gave you “The 5 reasons why you need to be difficult and demanding when your loved one is critically ill in Intensive Care”. You can read, watch or listen to last week’s update here.

    In this week’s blog I want to talk about “The 5 things you didn’t know you need doing whilst your loved one is critically ill in Intensive Care!”

    If one of your Family members has just been admitted to Intensive Care and is being treated there for critical illness, there is a very high chance that you and your Family feel very vulnerable, overwhelmed, frustrated, out of control, powerless without having any influence, you feel challenged and you are probably left struggling with this new situation that you, your Family and your critically ill loved have found yourself in.

    Worst of all, you feel like the decision making process around the treatment, prognosis and diagnosis for your critically ill loved is more often than not made without your consultation and input. After all, the Intensive Care team should know best, shouldn’t they? And that’s what the Intensive Care team will tell you implicitly or explicitly that they “know” what’s best…

    During a time of crises, you need to know what to do
    During a time of crisis like this it’s very easy to get caught in the opinions of “experts” and it’s very easy to lose sight of what’s important. Your emotions are probably running wild and you haven’t eaten or slept properly and you have probably spent day and night in Intensive Care to be with your critically ill loved one! You are probably physically and mentally exhausted and you and your Family don’t know what lies ahead…

    Rather than blindly following the Intensive Care team’s expertise, you may also consider doing your own research. After all there are many moving parts in a busy Intensive Care Unit that you and your Family are unaware of and those moving parts “behind the scene” so to speak, often have a dramatic impact on how the Intensive Care team positions themselves and also positions the prognosis and diagnosis of your critically ill loved one…

    If you don’t have the knowledge about the “behind the scenes” movements of an Intensive Care Unit and if you are unaware of the intrigue, the politics and the Psychology at play in an Intensive Care Unit you will do what 99% of Families of Critically ill Patients in Intensive Care do and follow the Intensive Care team blindly… (Related Article: The 5 reasons why you should not trust the Intensive Care team blindly if your loved one is critically ill in Intensive Care)

    after all you don’t know what you don’t know… and if you happen to follow the Intensive Care team blindly you’ll wind up having no control, power and no influence and you, your Family and your critically ill loved one are at the complete and total mercy of the Intensive Care team. Not a good position to be in.

    Going against the grain is often your best bet, so to speak
    If you want to be in that 1% bracket of Families of critically ill Patients in Intensive Care who have control, power and influence you need to go against the grain, you need to educate yourself and you need to get a different perspective!

    More importantly you need to educate yourself on the secrets of Intensive Care and therefore I want to give you some of those secrets that will leverage your control, power and influence whilst your loved one is critically ill in Intensive Care.

    I therefore give you “The 5 things you didn’t know you need doing whilst your loved one is critically ill in Intensive Care!” Once you know those 5 things you will set yourself apart from 99% of the Families of critically ill Patients in Intensive Care and you will find that if you apply the secrets that you learn at INTENSIVECAREHOTLINE.COM you will turn the tables in your favour and you will have control, power and influence!

    Again, before I dive into “The 5 things you didn’t know you need doing whilst your loved one is critically ill in Intensive Care!” you need to be aware that what I’m giving you here is contrarian advice to what everybody else is doing. Everybody else will just follow the herd or even worse will follow the Intensive Care team blindly…

    1.       Always question the prognosis and diagnosis for your critically ill loved one given to you by the Intensive Care team

    For somebody not familiar with Intensive Care, it’s easy to just take for face value what the Intensive Care team is telling you. It’s even easier to believe everything the Intensive Care team is telling you, given that your emotions are running wild and given that you are out of your comfort zone.

    Again, the contrarian advice here is to take your emotions out of the situation for a moment and contemplate what is at play here. Always keep in mind that Intensive Care treatment is very expensive, in an environment where people are constantly competing for scarce resources. You therefore need to find out whether your loved one’s stay and treatment in Intensive Care might compete with other interests.

    It is therefore that if you have been told that your loved one is dying or if the Intensive Care team suggests a “withdrawal of treatment” or a “withdrawal of life support” and you need to find out whether there’s a genuine clinical reason or whether it is a financial/ business reason or whether other Patients are awaiting admission into scarce Intensive Care bed.

    Related Article: The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    2.       You need to challenge the Intensive Care team on every level, especially if your loved one is approaching their end of life and/or if your critically ill loved one is facing a long-term stay in Intensive Care

    There are few situations in life that are more difficult, challenging and emotionally draining than having a loved one in Intensive Care who is either approaching their end of life and/or is a long-term Patient. Both situations tend to be terrible and often the Intensive Care team, as well as the Families and their critically ill loved ones are at a loss of what to do.

    The contrarian advice here is that you and your Family need to demand more of the Intensive Care team, in order to get the best possible treatment for your critically ill loved one. Often when you get told by the Intensive Care team that your loved one is dying, you need to question that assumption. Is the Intensive Care team not following through on your loved one’s treatment because they have other competing interests? Does the Intensive Care team have a limited mindset and therefore doesn’t believe in the recovery of your critically ill loved one? Does the Intensive Care team not want to invest the time, resources and energy that it takes to treat a long-term Patient in Intensive Care?

    Related Article: “The 5 reasons why you need to be difficult and demanding when your loved one is critically ill in Intensive Care”

    3.       You need to stop thinking that “the Doctors know what’s best”, because this belief is so wrongly ingrained in society that if you keep believing it, you are giving away your level of control, power and influence on a platter

    Know this: Yes, doctors and nurses are highly skilled professionals, however society also has this wrong belief “that they always know what’s best”. And that’s how they often position themselves, because society has allowed them to do so.

    Again, the contrarian advice here is to question their assumptions. How could Doctors possibly know what’s best for your critically ill loved one, if they don’t know your loved one personally? How do Doctors know how your critically ill loved one deals with adversity? Has your critically ill loved one beaten the odds before? Is your critically ill loved one resilient? If you only answered “Yes” to one of those questions, you need to listen to your gut and not to the doctors. If you know that your critically ill loved one can beat the odds then it’s time to tell the Intensive Care team and you should be doing that irrespective if the prognosis, diagnosis and positioning of the Intensive Care team!

    4.       Irrespective of the diagnosis and the prognosis you have been given for your critically ill loved one, you must know and learn about the moving parts in Intensive Care that are impacting the Intensive Care team’s positioning

    Both, the prognosis and diagnosis of your critically ill loved one, as well as the positioning of the Intensive Care team is usually heavily impacted by the moving parts behind the scenes in an Intensive Care Unit!

    Therefore, the contrarian advice here is to find out what the moving parts are in an Intensive Care Unit. Could it be that the Intensive Care team deems the treatment and therapy for your critically ill loved one as too expensive or not profitable? Could it be that having your loved one critically ill in Intensive Care for long periods of time would impact on other Patients awaiting admission to Intensive Care? Could it be that the Intensive Care Unit is not interested in treating your critically ill loved one to the best of their abilities, because it’s not their area of expertise, where the Intensive Care Unit can “shine” and get good publicity?

    5.       If you have been told by the Intensive Care team that your critically ill loved one is dying or won’t have any future “Quality of Life” after their critical illness, you must absolutely make sure that your values and beliefs are stronger than the Intensive Care team’s values and beliefs

    The Intensive Care team lives and breathes Intensive Care, every day. You and your Family don’t. It is therefore very easy to get caught and trapped into the mindset of the Intensive Care team. Given the stressful situation you and your Family are in, it’s very easy to forget about your values and beliefs!

    The contrarian advice here is to make sure that your values and beliefs are stronger than the values and beliefs of the Intensive Care team. The reality is that if your values and beliefs are not stronger than the Intensive Care team’s, they will walk all over you, because generally speaking 99% of Families of critically ill Patients don’t question and that’s their biggest challenge!

    Related Article: How to make sure that your values and beliefs are known whilst your loved one is critically ill in Intensive Care

     How can you further leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “blog” and I’ll see you again in another update next week!

    Make sure you also check out our your questions answered” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 5 things you didn’t know you need doing whilst your loved one is critically ill in Intensive Care! is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/5-things-didnt-know-need-whilst-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/4l_heWHmKwE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+things+you+didn%27t+know+you+need+doing+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 - Hi, http://youtu.be/4l_heWHmKwE https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+things+you+didn%27t+know+you+need+doing+whilst+your+loved+one+is+critically+ill+in+Intensive+Care.mp3 Hi, it’s Patrik Hutzel from INTENSIV... intensiv yes
    Calls for changes in end of life care! http://intensivecarehotline.com/calls-for-changes-in-end-of-life-care/ http://intensivecarehotline.com/calls-for-changes-in-end-of-life-care/#comments Sat, 14 Dec 2013 04:06:17 +0000 http://intensivecarehotline.com/?p=5208 https://s3-ap-southeast-2.amazonaws.com/intensivecareathome.com.au/Calls+for+changes+in+end+of+life+care.mp3 This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! […]

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    This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au

    In last week’s blog I was talking about that “Nelson Mandela is receiving Intensive Care treatment in his home!” If you haven’t read the blog, you can access it here http://intensivecareathome.com.au/nelson-mandela-receiving-intensive-care-treatment-home/

    Sadly, though, Nelson Mandela has passed away on the 5th December in his own home, whilst receiving Intensive Care in the home services. Thankfully he was able to die in a place where him and his Family felt at peace and he didn’t die behind sterile Hospital walls! Many of his accomplishments live on and will never be forgotten!

    In this week’s blog I want to pick up on a recent discussion, led by the Schools of Population Health at the University of Melbourne and Monash University earlier in the year. The meeting identified the need for improvement in end of life care and the associated barriers and drivers for change. In their position paper issued last month they are opting for “Calls for changes in end of life care”.  You can find a link to the original article at the end of the blog.

    An increasing number of people want to die at home if given a choice!
    In summary, the paper highlights that more than 52% of Australians currently die in Hospitals, despite the fact that according to some surveys around 70% of Australians would prefer to die at Home. In 2011 alone, more than 146,000 people died in Hospital.” A fairly large number of those people would have died in Intensive Care!

    The benefits of improving the system are multiple, extending to Patients and their Families where there will be improved quality of life-before-death, medical teams and carers to alleviate psychological, moral and emotional distress and conflict, and an improved allocation of resources within the health care system more broadly,” Professor McNeil one of the panel members said.

    How can we meet the challenges with end of life care? 
    Current practices in end-of-life care require major change to ensure more Australians experience “better” deaths, according to a panel of medical, ethical and legal experts.

    “People are living longer and consequently the practice of medicine and the way we live and die has changed,” Professor McNeil has been cited.

    “This creates new challenges for medical practice in particular, balancing the imperative to ‘cure’ with the personal, social and financial burden it can create. End-of- Life care implies an awareness of this balance.”

    A shift towards more home care would make perfect sense! 
    Certainly over the many years working in Intensive Care I have seen many Patients approaching their end of life slowly, often on a ventilator. In order to improve those Patients and their Families Quality of Life before death, a shift towards a more home care based approach even in an area such as Intensive Care would only make sense.

    I have also seen many Patients and Families in Intensive Care over the years who have asked for their loved one to go home and approach their end of life in their own home and achieve peace of mind in their own familiar surroundings.

    A lot more is possible at home than current clinical paradigms suggest and with successful models of INTENSIVE CARE AT HOME services overseas to look up to, we should start looking outside of Intensive Care in how we can improve Patients and their Families Quality of-Life before death, whilst also looking at more efficient resource management within Intensive Care!

    Albert Einstein once famously said: “You can never solve a problem on the level on which it was created.”, hence looking outside of Intensive  Care into a more Home Care based approach might improve Quality of Life before death for Patients and for Families.

    What are your thoughts? Do you think  that “Calls for changes in end of life care” are going to be a reality soon and how do you think it will impact on Intensive Care? Leave your comments here.

    As this is the last blog for this year I want to wish you and your Families a merry Christmas and a Happy new year and I’m looking forward in working with you in 2014!

    If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply send me an email to patrik@intensivecareathome.com.au.

    This is Patrik Hutzel from intensivecareathome.com.au and I’ll see you again in another update next week.

    Here’s the link to the original article.

    http://monash.edu.au/news/show/calls-for-change-to-end-of-life-care?utm_source=E-Healthcare+Brief+%28Current%29&utm_campaign=a1d121d348-AHHA_e_healthcare_brief_11+June_2013&utm_medium=email&utm_term=0_910dbd9c84-a1d121d348-245372681&ct=t(AHHA_e_healthcare_brief_21_March_20133_21_2013)

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    How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed? http://intensivecarehotline.com/long-take-critically-ill-loved-one-taken-ventilator-breathing-tube-endotracheal-tube-removed/ http://intensivecarehotline.com/long-take-critically-ill-loved-one-taken-ventilator-breathing-tube-endotracheal-tube-removed/#comments Mon, 09 Dec 2013 22:47:55 +0000 http://intensivecarehotline.com/?p=4403 ) https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+before+my+loved+one+can+be+taken+off+the+ventilator%26have+their+breathing+tube+removed-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained “How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP)?” You can read, watch or listen to the article here.

    In this week’s episode of “your questions answered” I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question that I want to answer this week is “How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed?”

    If your loved one has been admitted to Intensive Care for critical illness, chances are that he or she requires mechanical ventilation and therefore has a breathing tube(endotracheal tube) in their throat that is attached to a ventilator.

    Most critically ill Patients in Intensive Care require invasive(with a breathing tube/ endotracheal tube) or Non-invasive ventilation(also BIPAP or mask ventilation) during their stay in Intensive Care.
    Therefore, the question arises of how long it takes before the breathing tube(endotracheal tube) can be safely removed. Removing the breathing tube is also known as extubation.

    And just to quickly clarify, this blog is not about weaning from a ventilator with Tracheostomy. There are other articles that relate to weaning from the ventilator with Trachesotomy and I have put links to those articles at the end of this blog.
    So let’s just quickly look at what may lead to your critically ill loved one requiring a breathing tube or endotracheal tube and mechanical ventilation.

    The most common scenarios leading to mechanical ventilation are
    • Admission to Intensive Care after surgery- many types of surgery that require admission to Intensive Care require a Patient to be ventilated. The most common ones are Aortic Aneurysm Repair, CABG, heart transplant, lung transplant, liver transplant
    Induced coma
    Multi Trauma including Head and brain injuries
    • Ventilation and breathing difficulties like in Asthma, COPD, Pneumonia, lung failure(ARDS)
    • Other states of unconsciousness caused by Cardiac Arrest or seizures

    Those are the most common scenarios leading to mechanical ventilation and a breathing tube/endotracheal tube in Intensive Care and the list is not exhaustive.
    As a rule of thumb, mechanical ventilation and a breathing tube/ endotracheal tube should always be a temporary treatment and not a permanent one.

    Therefore, the goal is to have the breathing tube(endotracheal tube) removed as quickly as possible, as there are complications associated with mechanical ventilation.

    “As quickly as possible” generally means within a few days at the most or a 24-72 hour time span

    Lets quickly look at the major indications for mechanical ventilation and a breathing tube(endotracheal tube) and how long it normally takes to remove the breathing tube/ endotracheal tube

    • After surgery: the breathing tube/endotracheal tube after surgery should be removed as quickly as possible. Again as a rule of thumb, after Cardiac Surgery(CABG), Aortic Aneurysm Repair, Heart transplant, lung transplant, liver transplant within less than 24 hours, unless there are complications. All organ transplants have a high risk of complications associated and therefore ventilation might be required for more than 72 hours

    • After an Induced Coma the ventilator and breathing tube should be removed as quickly as possible, however “waking up” after an Induced Coma can take significant time and longer than expected and therefore a delay in taking the breathing tube out is not uncommon. Related Article: What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up? http://intensivecarehotline.com/what-could-be-the-cause-if-my-critically-ill-loved-one-is-removed-from-an-induced-coma-but-still-hasnt-woken-up/

    • Multi Traumas and Head Injuries can be more challenging situations and therefore may require for your critically ill loved one to be ventilated for more than 72 hours. Some cases may be ventilated for 7- 10 days before having the breathing tube removed. There is also an increased chance for your critically ill loved one requiring a Tracheostomy.

    • Ventilation difficulties and issues like in Asthma, COPD, Pneumonia shouldn’t require more than 72 hours of ventilation as well, however it depends on other medical issues as well. Again, medical issues associated with breathing like in Asthma, COPD or Pneumonia should give the lungs a rest during ventilation and once recovered the breathing tube/endotracheal tube should be removed as quickly as possible.

    • lung failure(ARDS) is more complicated and challenging and many Patients going through lung failure may require a Tracheostomy. Lung failure(ARDS) very rarely tends to be straightforward and therefore often requires prolonged mechanical ventilation.

    • Cardiac Arrest situations often require mechanical ventilation and an Induced coma as well. Especially after Cardiac Arrest situations, your critically ill loved one may require “cooling” for 24 hours as treatment of choice and therefore mechanical ventilation may last up to 72 hours or even longer.

    • If your critically ill loved one had Seizures they often require mechanical ventilation, a breathing tube and an Induced Coma as well, in order to protect the brain from having ongoing seizures and furthermore, Seizures often cause vomiting and therefore aspiration of stomach content into the lungs. The breathing tube tends to protect the lungs from aspiration of stomach contents. Aspiration can also cause Pneumonia. Again, as a rule of thumb, after the seizures have ceased and are controlled by medications, there should be no reason to keep your critically ill loved one ventilated and extubation(removal of the breathing tube) should be the aim within less than 72 hour

    I described the most common scenarios here in Intensive Care that require ventilation and a breathing tube and I have given you time frames for how long it takes for your critically ill loved one to be taken off the ventilator.
    Keep in mind that each case is different and individual and the advice given is general advice only.

    If again, your critically ill loved one is ventilated for more than one week, there is an increased chance that your loved one may require ongoing ventilation with Tracheostomy and I have put links to related Articles about Tracheostomy and ventilation below, at the end of the article.

    In any case, if your loved one is critically ill in Intensive Care and requires ventilation with a breathing tube and has been placed in an induced coma, chances are that you are out of your comfort zone and that you feel stressed, vulnerable, frustrated and overwhelmed by the experience of having your loved one critically ill in Intensive Care! It’s good that you are seeking help and independent advice, because unless you have done your own research, you should always question the Intensive Care team’s approach, because if you don’t question, you have no power, no control and no influence! The consequences of having no control, power or influence is that the Intensive Care team can drive their own agenda and their agenda may not be in the best interest of your critically ill loved one and your Family.

    I have learned this in more than 15 years Intensive Care nursing experience whilst working in three different countries around the world! You’d be surprised of how much goes on behind the scenes with the only purpose to keep you and your Family at arm’s length and the Intensive Care team has no interest in letting you see behind the scenes and the Intensive Care team doesn’t want you to have control, power and influence!

    How do you get to that all important feeling of control, power and influence whilst your loved one is critically ill in Intensive Care?
    You’ll get the important feeling of control, power and influence by downloading your FREE “INSTANT IMPACT” Report by entering your email below now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!
    In your FREE reports you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section or send me an email to support@intensivecarehotline.com with your questions!
    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely,
    your Friend
    Patrik Hutzel

    Related Articles:

    How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed? is a post from: INTENSIVE CARE HOTLINE

    The post How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed? appeared first on INTENSIVE CARE HOTLINE.

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    http://intensivecarehotline.com/long-take-critically-ill-loved-one-taken-ventilator-breathing-tube-endotracheal-tube-removed/feed/ 0 http://youtu.be/berkOR7alEU https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+before+my+loved+one+can+be+taken+off+the+ventilator%26have+their+breathing+tube+removed-.mp3 - Hi, http://youtu.be/berkOR7alEU https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+before+my+loved+one+can+be+taken+off+the+ventilator%26have+their+breathing+tube+removed-.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://INTENSIVECAREHOTLINE.COM) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another episode of “your questions answered” (http://intensivecarehotline.com/category/questions/) and in last week’s episode I explained “How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP)?” (http://intensivecarehotline.com/long-can-critically-ill-loved-one-stay-intra-aortic-balloon-pumpiabp/) You can read, watch or listen to the article here (http://intensivecarehotline.com/long-can-critically-ill-loved-one-stay-intra-aortic-balloon-pumpiabp/). In this week’s episode of “your questions answered” (http://intensivecarehotline.com/category/questions/) I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM (http://INTENSIVECAREHOTLINE.COM) and the question that I want to answer this week is “How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed?” If your loved one has been admitted to Intensive Care for critical illness, chances are that he or she requires mechanical ventilation and therefore has a breathing tube(endotracheal tube) in their throat that is attached to a ventilator. Most critically ill Patients in Intensive Care require invasive(with a breathing tube/ endotracheal tube (http://intensivecarehotline.com/breathing-tube-or-endotracheal-tube/)) or Non-invasive ventilation (http://intensivecarehotline.com/non-invasive-ventilationniv/)(also BIPAP (http://intensivecarehotline.com/bipap/) or mask ventilation) during their stay in Intensive Care. Therefore, the question arises of how long it takes before the breathing tube(endotracheal tube) (http://intensivecarehotline.com/breathing-tube-or-endotracheal-tube/) can be safely removed. Removing the breathing tube is also known as extubation (http://intensivecarehotline.com/extubation/). And just to quickly clarify, this blog is not about weaning from a ventilator with Tracheostomy (http://intensivecarehotline.com/tracheostomy-weaning-ventilator-intensive-care-long-can-take/). There are other articles that relate to weaning from the ventilator with Trachesotomy and I have put links to those articles at the end of this blog. So let’s just quickly look at what may lead to your critically ill loved one requiring a breathing tube or endotracheal tube and mechanical ventilation. The most common scenarios leading to mechanical ventilation are • Admission to Intensive Care after surgery- many types of surgery that require admission to Intensive Care require a Patient to be ventilated. The most common ones are Aortic Aneurysm Repair (http://intensivecarehotline.com/clinical-pictures/abdominal-aortic-aneurysm-2/), CABG (http://intensivecarehotline.com/clinical-pictures/coronary-artery-bypass-graft-cabg/), heart transplant (http://intensivecarehotline.com/heart-transplant/), lung transplant (http://intensivecarehotline.com/clinical-pictures/lung-transplantation/), liver transplant (http://intensivecarehotline.com/clinical-pictures/liver-transplant/) • Induced coma (http://intensivecarehotline.com/induced-coma-critically-ill-loved-one-induced-coma/) • Multi Trauma (http://intensivecarehotline.com/clinical-pictures/multi-trauma/) including Head and brain injuries (http://intensivecarehotline.com/clinical-pictures/traumatic-brain-injury-tbi/) • Ventilation and breathing difficulties like in Asthma intensiv yes
    Podcast Interview with ICUsteps.org CEO and Co-founder Peter Gibb http://intensivecarehotline.com/podcast-interview-icusteps-org-ceo-co-founder-peter-gibb/ http://intensivecarehotline.com/podcast-interview-icusteps-org-ceo-co-founder-peter-gibb/#comments Sun, 08 Dec 2013 23:00:14 +0000 http://intensivecarehotline.com/?p=4380 Listen to this second INTENSIVECAREHOTLINE.COM podcast, where host Patrik Hutzel interviews the ICUsteps.org CEO and Co-founder Peter Gibb! Patrik and Peter talk about Peter’s remarkable and inspirational story of how he survived his ICU stay as a Patient, what challenges he had to overcome and what eventually led him to start his own support group and […]

    Podcast Interview with ICUsteps.org CEO and Co-founder Peter Gibb is a post from: INTENSIVE CARE HOTLINE

    The post Podcast Interview with ICUsteps.org CEO and Co-founder Peter Gibb appeared first on INTENSIVE CARE HOTLINE.

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    Listen to this second INTENSIVECAREHOTLINE.COM podcast, where host Patrik Hutzel interviews the ICUsteps.org CEO and Co-founder Peter Gibb!

    Patrik and Peter talk about Peter’s remarkable and inspirational story of how he survived his ICU stay as a Patient, what challenges he had to overcome and what eventually led him to start his own support group and help other ex-Intensive Care Patients and their Families to find meaning in their ordeal and how to effectively deal with their challenges after coming out of Intensive Care!

    Sincerely, your Friend

    Patrik Hutzel

    Here’s the interview transcript:

    INTENSIVECAREHOTLINE.COM Podcast

    Interview with Peter Gibb CEO and co-founder of ICU steps.org

    Patrik: Hello and welcome to INTENSIVECAREHOTLINE.COM , where we help Families of critically ill Patients in Intensive Care to instantly improve their lives so that they can have more control, more power and more influence!

    I’m your host, Patrik Hutzel, founder and editor of INTENSIVECAREHOTLINE.COM and as part of our interview series, today I’ve got a very special guest, Peter Gibb, the CEO and co-founder of ICUsteps.org,  a support website for  ex- Intensive Care Patients, their relatives and ICU staff, to support ex- ICU Patients and their Families through the long road of recovery from their critical illness.

    Welcome Peter, thank you for coming on to the show and how are you today?

    Peter: Hello Patrik, I’m very well and thank you and thank you for inviting me!

    Patrik: Your more than welcome, I mean we’re always looking for great stories and for inspiring people and Peter you are the co-founder of ICUsteps, which, as we mentioned is a support website for ex-ICU Patients that I mentioned in the introduction. And we come there to the first question straight away. What has led you and more importantly, what has inspired you and what was your main motivation to start such a great and much needed support platform? And I’m sure many of our listeners are probably also interested in your personal story, if you are willing to share.

    Peter: Of course, of course not a problem. Well, it started for me 10 years ago, I was a keen amateur mountain biker and in training for a holiday in the French alps, I actually, in which near my home had a mountain biking accident, whereby I apparently, I don’t remember the accident, or the day of the accident myself, but in taking a jump that I’ve done many times before, something went wrong and I landed head first full speed, resulting thankfully I was wearing a bike helmet, which saved my life and, but I was still left with brain haemorrhage, a broken neck, a broken back in two places, a broken rib and a punctured lung.

    I was fortunate enough to be airlifted by the local air ambulance to Milton Keynes Hospital, where I spent just over three weeks in Intensive Care.

    My first memories were very late on in Intensive Care and I had no memories of the accident, I had no pain because I was being pain managed and because of the head injury and I believe delirium, I didn’t believe any of the stories that have been told to me. So it was very much like waking up in the matrix.

    I spent a further three weeks on a general ward, where none of the other people around me or did the health care professionals seem to understand what I was going through. I believed that this was just me, this can’t be normal and it got to the point where I emotionally blackmailed my wife to help me escape.

    Patrik: Wow!

    Peter: I told her if she didn’t help me I would try when she wasn’t there and I probably end up dead somewhere! And again, it’s partly in retrospect I can see the immense pressure that relatives are under at that time as well! But she did help me, I think she was hoping that the staff would stop her and would understand the situation and get me the help I needed at that time. But they didn’t and so I escaped. I happened, luckily through several forms of help, partly through the follow up with the head injury nurse that I had seen.

    I was also fortunate enough to be in one of the 30% of UK hospitals with an ICU follow up clinic and because of my head injury I also was seen by the local head injury clinic.

    So that was the support that I had after the hospital.  Then probably about 12-18 months after the accident and some follow up visits that I mentioned, I got a letter from the follow up nurse, inviting me back to a meeting, to see if there was something we could do, to help other people that are going through Intensive Care.

    I felt a bit of a fraud because I didn’t really remember being in Intensive Care. I didn’t think that three weeks in Critical Care was that long of a time.

    Three days is regarded as quite a long Critical Care stay.

    I went along to the meeting largely because, well two points I think.

    One, an immense amount of guilt, for all the trouble I caused so many people through my own stupidity and also because I believed that relatives needed something. If at that time I had an understand that during those darkest hours, when our lives as Patients are in the balance, we, we’re kind of OK, you know, we were being sedated, we were being pain managed, but it’s our relatives who are living each second not knowing what the outcome is going to be and I cannot imagine how dreadful that must be.

    As it turns out when we end up and drop hints, it is actually still the Patients that need the support at those final stages of normalisation back to being a normal person rather than a Patient again. For relatives they find help as well to be able to talk to other people who can actually understand them, because they’ve been through those experiences as well.

    Patrik: Absolutely! I mean what I can see, what you’ve just described, I mean, from my perspective, having worked in Intensive Care for 15 years, once the clinical things are under control, once Patients are being managed, quote and quote “managed”, then it’s all about Family management. But , what do you think are the main challenges that former Intensive Care Patients and their Families are confronted with? And I mean, I can see some of those challenges on your website when ex- Intensive Care Patients describe their nightmares, their pains their frustrations. And how does ICUsteps.org help those Patients? If you can sort of describe that a little bit that would be great.

    Peter: I think, you’ve touched on it already. For people that actually are “in the know” and sadly it seems to be the minority, the people that actually work in Intensive Care, is the physical, the psychological  and the cognitive deficits that Intensive Care Patients can be left with.

    It seems to be a result of critical care and the treatment itself, rather than necessarily the specific reason for critical care admission.  That’s always the thing that never ceases to surprise me, is despite the vastly different reasons for our admission to Intensive Care that we have this commonality of experiences, this great big ball of stuff to deal with and so often we go through it believing we’re the only person in the world that’s ever experienced this, because if it was normal somebody would have told us.

    Patrik: And it sounds very personal what people are going through. It’s sort of, even though there are commonalities, the way people describe it from what I can see, it’s very emotional , it’s very personal, sort of, you know, it’s almost they can’t believe it themselves, that’s what it sounds like to me.

    Peter: You’re absolutely right.  I mean, I think, again, one of the cruelties for me, is that we will be managed, as I say pain managed, so we won’t be in our right mind, we won’t be fully aware of what’s going on and really in that time in Intensive Care and I know it varies depending on how long you’re in the ICU and the specifics of your treatment. But so often it comes to the point, where you  start to be weaned off the drugs, you then start to get your own mind and personality back and then bang, you’ve gone out of Intensive Care.

    And you’re removed from the people that actually understand and can explain what the after effects would be, what’s normal, what’s OK and the people around you from that point, be it general ward staff or afterwards into the community, say you’re GP, will have very limited understanding, if any, of the sacrilege of critical illness, the things that can follow on from the treatment.

    Patrik: So what you’re describing there is almost like, OK well in ICU health professionals have an understand of what’s happening but as soon as Patients leave Intensive Care, whether it’s ward nurses, GP’s, any other professionals that you come in contact with have really no idea, understanding, empathy for the horrible experience you have been through.

    And I believe as part of icusteps.org, you also have local support groups for ex- ICU Patients and their Families across the UK. I’m sure our listeners would like to know more about those groups. How do you structure those meetup groups and what value do you think people get out of those groups?

    Peter: The  group really, that was where we started and the website actually followed on as a result from that, but the very reason behind that was really what we already touched upon. It’s that point that, as soon as someone is no longer technically regarded as being critically ill, they can be bounced to anywhere in the hospital and when they get there, no one seems to understand what they’ve been through and what lies ahead for them.

    And it’s that isolation from those like us who can help. Just say “oh yes, yes, I have that as well” and just knowing you’re not on your own, can take away so much of the worry and the concern and that’s where the support idea came from. It was about getting Patients back together just so that you can talk to each other, understand each other and share the stories with people that actually understood them.

    Patrik: Yes. And I can see a lot of similarities when I read the comments on icusteps.org, I can see a lot of similarities what Patients have gone through in terms of nightmares, six months later they’ve still got depression and you know they look OK to the outside world physiologically, what’s happening inside seems to be very troublesome, worry some and nobody seems to understand them and that’s why I think, you know, what you’re doing there with icusteps.org, building a community of people who have been through the same experience that very few people actually seem to really understand on a basic level, I mean that must be, that must be extremely valuable for those ex ICU Patients

    Peter: This certainly and speaking as an ex- Patient myself, I would have to say that I did as well, find it a great relief to feel, to feel that you’re not going mad, I mean that’s an expression that nurses who run follow up  will often hear. And that could be one of the difficulties I think there’s still, something of a stigma around mental health issues and if you’re actually going through this, you can be quite reticent to raise it or even admit it, for fear of being classed as being mentally ill.

    And it’s a horrible state of affairs to be in. and as I said it’s the, it’s the commonalities of the things that we experience. So once you can start peeling away, these things are actually normal, so the, you know, rigidness of your fingernails, maybe some hair loss, changes to your sense of taste, your sense of smell, muscle weakness, the psychological aspects, the anxiety, the depression, the nightmares, when you can actually peel away all these things that are normal, you will still be left with some things which are just you that are related specifically to the critical illness that you had and why you were in ICU. But when you peeled away all those common things, those, those still very serious issues that you’re left with, seems so much less daunting, because they are not wrapped up in all this other stuff.

    And again, you know, being able to talk to people and just help evaporate these concerns away. It’s just, it’s such a simple thing to do, but it makes such a big difference!

    Patrik: It sounds like to me like it makes such a big difference and what I can see, you know, what you’re describing there and what I can see form a health professional point of view, obviously being an ICU nurse, I find myself amongst my colleagues like a “Fish in water” and we simply don’t know what we don’t know. One of the challenges and frustrations that I find is that as soon as a Patient leaves Intensive Care, we as ICU staff have no idea what’s happening from there.  It would therefore be extremely valuable for Intensive Care professionals to get feedback from ex Patients, in how they went, because then our work would probably feel more complete.

    With the feedback, we would also be able to look at our current practices in Intensive Care and how we could improve those practices, in order to have ex- ICU Patients, not only deal with fewer challenges and issues after they’ve gone home, because again, for me it’s mind boggling what, the comments that I read on icusteps.org, because you know, obviously we do our work in Intensive Care, but until I read what’s, what people describe on your website, I really had no idea what people are going through after Intensive Care and I’m sure a lot of ICU professionals have no idea what people describe six months later after their stay in ICU.

    Do you think that Intensive Care staff, whether Doctors or Nurses should know more about the challenges ex-ICU Patients are dealing with, in order to improve current practice in ICU? And what are some of the challenges ex-ICU patients are dealing with in particular, once they are at home? And I know you’ve touched on some of them, but maybe you can sort of describe them a bit more vividly or in detail?

    Peter: Well, to answer the first part of the question, yes absolutely. There’s a massive appreciation, a universal appreciation I would say amongst ex Patients with gratitude. We understand that the Intensive Care professionals have quite literally saved our lives. If you’re not, if your life isn’t in the balance and you know, you’re not good to be lucky enough to get an Intensive Care bed. So it’s only the very sickest Patients and it’s that amazing job that the ICU professionals, the whole multidisciplinary team do, in turning us around from the brink and bringing us back.

    And you’re absolutely right, we, when we’re no longer regarded as being critically ill and we’re on the path to recovery, we’re shipped out to a) another ward, with, if we’re lucky a care plan, which may or may not be fully followed through and implemented.

    But as the emergency team, the ICU professionals may not generally see the Patients after that. Depending on whether you have follow up or any other sort of aftercare. I’m sure you will, you will get Patients and their relatives coming back to the unit. I certainly know many, many Patients and relatives who have wanted to go back to say “Thank you”.

    But one of the strange differences with Intensive Care is this kind of break in responsibility, with another sort of serious health issues, say if it was cardiac or something along those lines, there seems to be a more consistent pathway and that they’re more acute sections and then more general sections and rehabilitation sections. But Intensive Care seems to a bubble, I mean sort of and as soon as you’re no longer critically ill then that, you loose that continuity of care.

    Patrik: It really does.

    Peter: So it’s a difficult, it’s a difficult area, particularly given the number of areas that Intensive Care can bring its own difficulties for the Patient going forward, that, they don’t have that access back to the people who understood.

    So the experts, they may know, some of them may know the consequences that are followed on, but like you say, if that, that’s one of the things we’re trying to do, highlight those issues and encourage education amongst ICU professionals, on sort of follow on to what can happen from that. But that’s when it’s within a very specific specialism. As soon as you go to the next stage of general ward based care or even a further stage on to general practitioner, you’ve got such a dilution of experience with critically ill Patients, that there is an almost complete lack of understanding of what we’re going through. And that makes the, the recovery and rehabilitation that much harder .

    Patrik: And I think what you’re describing there, one of the challenges that I can see is, you know, sort of, because Intensive Care is so specialised and as ICU professionals we tend to be so focused and absorbed in what we are doing, during that critical illness and there’s no excuse for that but I think we simply forget about looking after our Patients after Intensive Care and you know and I don’t know the answer to that issue, but I think, you know, ICUsteps.org is certainly one step to sort of looking after Patients, you know, after their ICU stay, but I do think there needs to come more out of, out of Intensive Care to sort of, you know, I think a lot of ICU professionals are just simply…they don’t know what ex- Patients are going through and it would be eye opening for, for most ICU professionals to, to have a look into that world, you know, sort of what people describe. I think it would change our, it would change our paradigm, hopefully. And a lot of medical and nursing practice in Intensive Care is evidence based and it’s frightening and scary to find reports on your icusteps.org website from ex-ICU Patients, what this evidence based practice is doing to them and the massive issues they are dealing with after they survived their Intensive Care stay.

    How do you think ex-ICU Patients need to get involved in changing some of those practices and current clinical paradigms in order to come out better at the other end?

    Do you also think that what some ex-ICU Patients report is a form of PTSD or Post-Traumatic- stress disorder?

    Peter: Certainly a number of, a notable percentage of recovering ICU Patients will have PTSD and even, even those that aren’t actually exhibiting full blown PTSD will have many, many of them will have symptoms of post-traumatic stress, I’m sure. And of course PTSD can also effect relatives.

    Patrik: Absolutely!

    Peter: So it’s not just restricted to the Patients. It does seem to me that, that Intensive Care is a comparatively, a comparatively young discipline, compared to other areas of health care and so often it seems that people are just using their, their clinical judgement and their, for lack of better expression, their best  guess, as to what can be done and because it is such a delicate moment, that life is in the balance and they’ve just got to do everything that they can and it’s only when they started to turn these around in a more repeatable way that we can start trying to improve things and I think it is happening. Even, even in Southern Europe it’s quite common that Patients, Intensive Care Patients be physically restrained and not sedated, which to me as an ex-Patient seems terrifying. And not surprisingly the evidence showed and Dr Christine Jones who’s one of our trustees now, was involved in a trial that highlighted this and that the practice in Italian hospitals actually had higher incidences of PTSD.

    Patrik: Right!

    Peter: But the simpler one, the equal but opposite side of that is that the previous practice in sort of northern and western Europe was to sedate Patients, to keep them out of the equation altogether . It made the healthcare professionals life simpler, because they didn’t have to worry about what the Patient was doing or as I did myself- and I put my hand up there- pulling out my lines and my tubes and we thought that it would be better if we didn’t remember this awful time and of course the truth of that is that the deep sedation brings its own specific psychological issues that we have to face.

    And the missing time is, was certainly for me was one of the biggest issues that I couldn’t wrap my head around. And even there I mean, things now are starting to improve with things as simple as ICU diaries, as photographs of us in this state that we can’t remember. You know the old adage “a picture tells a thousand words”, it really, it really does!

    We’ve still got the whole issues around litigation and consent, but they are really not reasons to not do it. Everything else has been done to us without our consent, because it’s in our best interest.

    So, to get back to the question, I think now that we’re getting to a point where increasing numbers  of Patients are imagined to survive from conditions that previously they couldn’t have done, we can start, we can start looking at how these things can be improved and I’m very happy to say that I’ve come across a great many Intensive Care health professionals, who believe passionately that this needs to be done and it doesn’t seem to be, certainly my, my experience, like so many other walks of life, where people just go in, they do the hours, they do the job, then they hang up the coat and go home, these people are very, very passionate and I’m convinced that things will get better!

    And unfortunately, well, maybe not even unfortunately, but things have to be done on an evidence base. And that means that research has to be done, very difficult to get the nice gold standards of randomised control trials for Intensive Care, so we’re up against it there, but the best evidence possible has to be gathered so we can, we can improve practice and part of that will be recruiting Patients and relatives.

    So that’s one of the things that icusteps does as well, is helping in healthcare research where we can.

    Patrik: Right! And from what I can see as well Peter, is you know, I mean, the Internet is taking, from my perspective barriers down in many industries, you know, if you will and I think healthcare in a sense is only at the beginning there, I think it’s lacking behind other industries, for a number of reasons.

    But I do think that in this day and age, the internet and social media is both on the rise obviously and you know, now we have the opportunity to share those stories online, like you do on your icusteps.org website, it hopefully gives, gives whoever is interested in that topic insight and hopefully it’ll drive change from there really, because you know, as you mentioned, it’s, I think it’s quite important to have ex- Patients and their relatives involved in evidence based care, to sort of change practice and hopefully avoid some of those nightmares that ex-Patients are going through.

    Peter: Absolutely

    Patrik: And do you think that what I’ve just mentioned with the Internet and social media on the rise, do you think that Patient and Family support inside and outside of Intensive Care is taking on a different sort of trajectory and do you think there is now more transparency and support regarding critical illness in Intensive Care?

    And where do you see the future there?

    Peter: I think that one, that one for me is a little bit trickier. The, we are such a diverse Patient population, we’re very small Patient population I should say and that means that we’re very widely spread, so the chances of actually just happening across to another Intensive Care Patient is fairly limited, so using online tools, it’s so much easier to get in touch with other people who can, who can understand you.

    So, so if you’re not physically near a drop-in session or say an icusteps support group, there’s always the community, there’s always people that you can reach and obviously that is a big, big help.

    But as a, in my day job, outside of ICUsteps, I’m actually a web-user- interface developer, so I’m also very much aware that you can, if, whatever you want to search for in the web, you can find something to support the belief that you have, whether it’s right or wrong.

    And in medical issues that can be a little bit more concerning, because obviously you need to get honest answers rather than necessarily just finding people who will, will agree with you, but maybe the information is incorrect.

    So there’s a little concern there, but that’s where I think the involvement of health care professionals with that, say with the online communities can be a big relief as well.

    Again, one of the things we try to make sure let’s say in the drop-ins or in the community, is to suggest possibilities for Patients to take out with their own healthcare team.

    Because we can only see one small aspect of what’s being presented, we don’t have access to the case notes or the full medical history. So we can give the benefit of our experience and what other people have said, but it maybe that when that’s applied to the wrong particular cases, it’s not entirely the same.

    So this needs to be guided and dealt with, with care.

    Patrik: So what you’re basically suggesting is, with, you know, obviously health being the industry it is, a lot of research, evidence based and that sort of stuff, what you’re basically suggesting is, it needs to be put in a framework in order, you know, to not only look at subjective experiences and maybe take them out of context, but keep them within a sort of framework guided by health professionals? Is that sort of what you’re…

    Peter: Yes, I think that puts it well. I mean, there is a, if I can go off on a bit of a tangent for a second…

    Patrik: Yes!

    Peter: There is a very strong driver in healthcare at the moment that you know, “don’t tell the Patient what you’re going to do”. Tell the Patient what the conditions are, give them their healthcare options and let them make a decision.

    But I think with critical care, there’s a chap called David Rear, who was a medical sociologist in Israel, wrote a paper back in 2000 on the disappearing voice of the critically ill Patient and he was very much in the camp of “don’t tell Patients what you are going to do, tell them what their options are, what the consequences are and let them decide.” Until he himself was critically ill and he tells of times when he wasn’t told just how ill he was and how he believes that that was crucial in his survival.

    So, not, not that he was lied to but, but be in completely honest with people who are that ill can actually potentially have negative effects, which actually went again, again all of his beliefs in his training.

    But in Intensive Care that kind of more old fashioned, almost paternalistic style of healthcare can actually still be beneficial. But there’s still a point where that, that approach needs to be dough tailed back into a more considered approach and returning self-determination to the Patient.  (34 min)

    I mean the other thing you were mentioning about, evidence based and obviously we appreciate with finite resources, evidence base healthcare is understandable. One of the things that we’re very happy to be working on is collaboration with an organisation called the “James Linder Lines” and what the “James Linder lines” do is that they gather information from Patients and their Families, as to what is it that they, as in Patients and Families find the issues to be. What are the areas, where they would like to see research done?

    So rather than research just being driven, the research is generally driven by researchers, just based on what the  particular person find of interest, actually sort of saying to Patients and relatives, these are the things that matter!

    And so that then follows on and then the organisations who provide the funding for the research, start to pay attention and if you want to get your research funded, you have to be seen to be taking on the issues that actually matter to Patients and relatives. So that’s a very positive step for me!

    And something that we’re only too happy to assist with.

    Patrik: Right, right, that sounds very good! It sounds like there is definitely, sort of, sort of, there are some improvements happening in that area, where obviously Patients and Families are getting more involved, which I think is a great step, I mean and I personally think that there is a lot of room improvement in Intensive Care, to improve Family support and my personal experience has shown that once the Patient’s clinical issues in Intensive Care are under control and managed, it’s all about managing and supporting Families! I also think that Intensive Care teams tend to be extremely good clinicians and experts in their field, however I do feel that most ICU’s don’t offer enough support and communication towards Families of critically ill Patients in Intensive Care! I also believe that ICU’s have a long way to go there, which was one of the main drivers for me to start a support website, that’s specifically aimed at Families of the critically ill.

    Because I believe Families are thrown out of their comfort zone in an instant, as soon as their loved one has been admitted to Intensive Care and they often feel helpless and totally out of control. What’s your experience with Family support in particular and do you see any room for improvement there?

    Peter: I have to say, I mean obviously, having first- hand experience with critical illness, I don’t have first- hand experience of what it’s like to be a relative. I’m quite happy that’s the case.

    But obviously I talk to many relatives over the 10 years that we’ve been going and generally, I don’t know if this is different in the UK, but generally the relative experience hasn’t been too bad. They felt that they have been able to ask questions of the health professional looking after their loved one, the Patient. They have obviously, they have the usual of not wanting to leave the Patient’s side, being worried, there do seem to have been some movements in the past couple of years with relative visiting rights becoming slightly more restricted, but that’s something we assisted the British association of Critical Care Nurses with, in producing their position statement on relative visiting and, and really letting people know that it’s not just about treating the Patient, it’s about treating the whole Family unit!

    Patrik: Absolutely!

    Peter: So there is, there is work to be done to ensure that that isn’t lost in the overall goal of saving a Patient’s life!

    But the other thing that I found worse rather than the Intensive Care experience itself, which seems to be understood and when there’s difficulties the relatives understand why that is. It’s after we leave Intensive Care, to the point that relatives are- the Patient I should say, is assumed to have mental capacity far sooner than what actually in our right mind enable to make decisions for ourselves! So, on the general ward it would be quite possible for relatives to be excluded from consultations, from the decision making process, even from their opinion on the Patient’s mental state. Because after all who is gonna be in a better position to say whether the Patient is acting normally for themselves or not.

    Patrik: Absolutely!

    Peter: The person who actually knows them!

    Patrik: Exactly!

    Peter: So of course the general ward staff are almost trained to push the Family back. “You’re just an interested bystander, it’s the Patient that matters”! And then of course, as we know, the length of time it takes to recover from critical illness, both physically and psychologically, who is it, who’s going to have to provide that support when the Patient leaves through the  front door of the hospital? It’s the relatives. You know they are proxy, caregivers and if they can actually be excluded from the whole process, even in the general ward stage and then expected to pick up the pieces afterwards, it just is an appalling failing in the whole continuity of care!

    Patrik: Absolutely! And one thing that I always sort of say to Families and in Intensive Care, sort of, even though, you know we’re sometimes dealing with very critical situations, where, you know the outcome of our treatment is uncertain. The way I look at Patients often is, you know, I sort of say to the Family, you know, “what do you think?”, I mean, “How has your loved one dealt with adversity in the past?”, you know, “what do you think?”, you know and that goes off the beaten path of evidence base, you know.

    I say to them, you know “What do you think? These are the clinical facts and it looks pretty grim, but what do you think? Has your loved one been in a situation like that before? How are they dealing with, you know, adverse events in their lives?” And you know, I sort of think that’s a good indicator in how they might actually come out at the other end.

    And again that’s going totally off the evidence base, a lot of clinicians don’t want to hear that sort of stuff, but my experience shows that if a Family comes and says “Look, we want to continue treatment, because our father, mother has come out of this in the past you know, they’ve dealt with cancer 10 years ago and they survived that, we believe he or she will survive that as well and you know, I think, we should listen to those voices, because, you know, they know, what you’ve just said, they know their loved one best! It’s not us the clinicians, it’s the Families who know their Family member best and how they deal with adverse events really.

    Peter: Well, it’s an absolutely valid point you have there, I mean some healthcare professionals may not necessarily buy into that straight away, but I haven’t met a health professional yet, who hasn’t agreed with the idea that a positive mental attitude has better outcomes!

    Patrik: Absolutely!

    Peter: And it’s really just a different point on the same sliding scale in my ideas.

    Patrik: Absolutely! And Peter, where and how can people find out more about your website? And can people also help support ICUsteps.org through raising funds?

    Peter: Well, you’ve hit the nail on the head there already, it’s ICUsteps.org is the website. We do have a community as well, which can either be accessed through the website or directly at ICUsteps.healthunlocked.com

    And in terms of support, it’s not so much financial support that we need, it never really has been. It’s about people getting involved and volunteering their time and their expertise.

    The support groups that you’ve mentioned, they are actually all independent groups. They have our name and the members of our organisation, but they tailor their groups to bring in whatever(44:10) works for them on a local level. The groups themselves that’s a whole other topic , but to cut to the chase, it’s a partnership between healthcare professionals and motivated, capable ex-Patients and relatives that can provide that service and whenever we can get that nucleus of health professional and ex-Patients and relatives together, then there’s a chance for a group to start-up!

    The more of these groups that we have and that they’re able to feed back into ICUsteps as the national and after recent conferences, including one in Sweden, just this last week, it does seem there is more of a pressure for us to become international, but I’m not quite sure how that would work out…

    Patrik: Look, I mean… Yes, sorry, go on.

    Peter: I think the care is universal, but as we get more of these groups going and we get a, I mentioned how widely scattered and how small of a Patient population we are, but if we can get more of these individuals involved, then my hope is that we can actually start providing a clearer, stronger, louder voice for Intensive Care Patients, that is representative of all of us!

    Patrik: And I mean you’ve just mentioned you know, obviously, it’s becoming more of an international movement already, but I believe your ICUsteps.org is sort of, it’s partly NHS supported or funded, even isn’t it? Like the National Health Service in the UK is definitely involved in that group?

    Peter: It’s UK based. We recommend that our support groups are independent of hospitals, simply because that, that expertise isn’t needed. The health professionals have a very valuable and important role to play, but the Patients and relative members of support groups can do a lot of the heavy lifting. As I put in the talk, we don’t need a nursing degree in order to make the coffee.

    So in actual fact, from my mind it’s actually being able to go from being the recipient of the care to being someone who is able to help other people is that final part of the journey, from being an ICU Patient, back to being a normal person again!

    And I think if it’s something that’s formally attached to the hospital, that really takes the aspect away, it becomes more of a hospital service that you’re helping out with.

    And I think it can increase bureaucracy and that sort of thing. That, having been said, links with hospitals are, of course, vital, because they are the providers of the raw material for support groups, the actual ex-ICU Patients and relatives themselves! So it’s kind of, there is a relationship, but it’s hopefully more symbiotic than actually entrenched.

    Patrik: Yes. And what you’ve just mentioned, sort of, helping other ex-ICU Patients, do you think that’s helping, sort of Patients who are willing to share their experience and support other ex-ICU Patients, do you think that’s part of a healing process as well?

    Peter: Oh, absolutely it is yes! Even being able to verbalise your own story, can help put things into perspective and let you be more at rest with them. But if you can actually end up helping someone else as well, then it just gives purpose to everything you’ve been through!

    And that in itself for me was one of the big drivers that makes you feel that it was worth everything you’ve been through, even the more difficult, the hard times, there was a reason for that and you know you’re getting every ounce of goodness  out that you can!

    Patrik: That’s fantastic! Do you have, Peter do you have any final advice for ex-ICU Patients and their Families?

    Peter: Advice? One of the things, we’re trying not to give advice, but what I would say to ex-ICU Patients and their relatives, the number one thing is, you’re not alone! There are other people out there, who have been through things and that they can understand you! The fact that no matter how badly we’ve had to  endure, we always find people that are worse off then ourselves and being able to do something to help others is a massive, massive benefit in coming to terms with our own experiences!

    And the other thing is, it does seem that although the experience, the consequences of critical illness are universal and I say that because from the contacts we get from around the globe, despite the different healthcare systems it’s so often that the common things just keep cropping up again and again and again. And although we are getting better at, the health professionals getting better at saving people’s lives, we do still seem to be stuck in this rather backward, almost post first world war mentality of, well “we’ve saved your life, what do you want?” and really, rehabilitation is so often seen as, as a fluffy ad-on that’s not necessary, when in actual fact, it’s absolutely crucial in returning Patients back to be normal, productive members of society.

    And when so much money, time and effort has been spent on getting us to a point where we’re not, where we’re not expected to die, the relatively cheap treatments and facilities that rehabilitation offer makes such a massive difference. I mean my belief is that they would actually save money.

    Patrik: Yes!

    Peter: If you actually, sorry, if you were to look at the cost of rehabilitation as compared to the cost of an Intensive Care bed, maybe it’s like adding an extra half day’s Intensive Care bed or day’s Intensive Care bed on to the cost of treatment. But for that cost you get reduced ICU readmission, reduced hospital length of stay, reduced GP visits, you, you get less access to social benefits, because we go back to work sooner and we start paying tax sooner!

    Patrik: Absolutely!

    Peter: So I’m convinced, I’m absolutely convinced that if you look to the big picture, rehabilitation actually saves money, but unfortunately because it doesn’t come out of the right pots or people are looking after their own particular expense pots and they don’t have a helicopter view or for the big picture, sadly that seems to still be an uphill battle, but we’ll work on that one.

    Patrik: Yeah for sure, because I think it’s a big challenge, I think Intensive Care is sort of a very close community and what you’ve just mentioned there, not looking at the bigger picture I think is part of many of the issues within Intensive Care and what you’ve just mentioned there “guilt” that some Patients may even feel, sort of “you know they’ve saved my life, you know I couldn’t ask for more, but as we know, there are a lot of other issues that come up after their ICU stay and we definitely do need a, I think a bigger picture view and see how we can tackle those issues from, from other ankles as well. Because it’s just not as simple as “yeah, we’ve saved your life, you know, now move on”, that’s not, that’s not what happens in the real world.

    Peter: No., absolutely not.

    Patrik: Well, Peter I really want to thank you for coming on to this interview and you’ve shared some tremendous insights there that I hope our listeners will find valuable and you know if, if they either have been through the experience of being an Intensive Care Patient, I’m sure they can get a lot of insight on ICUsteps.org or if they are a Family member of an Intensive Care Patient, they can find lots of FREE resources at INTENSIVECAREHOTLINE.COM

    So again, really thanking you for coming on to this interview and being our guest here!

    Peter: Thank you very much Patrik!

    Patrik: Oh, you’re most welcome and yeah thank you our listeners to, to listen to this second episode of our INTENSIVECAREHOTLINE.COM interview series and we’d definitely continue this series next month with another special guest and thanks again for listening and good bye Peter in the UK and…

    Peter: Good bye Patrik

    Patrik: OK, thank you very much! Bye, bye!

    Peter: Bye, bye

    Podcast Interview with ICUsteps.org CEO and Co-founder Peter Gibb is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/podcast-interview-icusteps-org-ceo-co-founder-peter-gibb/feed/ 0 Listen to this second INTENSIVECAREHOTLINE.COM podcast, where host Patrik Hutzel interviews the ICUsteps.org CEO and Co-founder Peter Gibb! - Patrik and Peter talk about Peter's remarkable and inspirational story of how he survived his ICU stay as a P... Listen to this second INTENSIVECAREHOTLINE.COM (http://INTENSIVECAREHOTLINE.COM) podcast, where host Patrik Hutzel interviews the ICUsteps.org CEO and Co-founder Peter Gibb! Patrik and Peter talk about Peter's remarkable and inspirational story of h... intensiv yes
    How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP) in Intensive Care? http://intensivecarehotline.com/long-can-critically-ill-loved-one-stay-intra-aortic-balloon-pumpiabp/ http://intensivecarehotline.com/long-can-critically-ill-loved-one-stay-intra-aortic-balloon-pumpiabp/#comments Mon, 02 Dec 2013 22:46:27 +0000 http://intensivecarehotline.com/?p=4280 ) https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+my+critically+ill+loved+one+stay+on+an+Intra-aortic+balloon+pump(IABP)-.mp3 Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is […]

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    )

    Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up?” If you haven’t read it, you can check it out here.

    In this week’s episode of “your questions answered” I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question that I want to answer this week is

    “How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP) in Intensive Care?”

    If your loved one has been admitted to Intensive Care for critical illness and is now requiring an Intra-aortic-balloon pump(IABP) chances are that your critically ill loved one has suffered from a major heart(cardiac) event such as a heart attack(myocardial infarct), Cardiac Arrest(sudden stop of the heart) or Open heart surgery(CABG).

    These are the most common scenarios that lead to a weakness of the heart and more importantly a weakness of the heart muscles so that the heart muscles are too weak to provide sufficient contraction to pump the blood going through the heart chambers around the body to all other organs.

    In any case, you and your Family want to get as much information as possible, because if you’re not getting advice from other sources, the Intensive Care team may only tell you a one sided story. Therefore, it’s a smart thing to do to check out other resources such as INTENSIVECAREHOTLINE.COM

    Furthermore, prior to your critically ill loved one suffering from a heart attack(myocardial infarct), Cardiac Arrest(sudden stop of the heart) or going for Open heart surgery(CABG), the leading cause for  a heart attack(myocardial infarct), Cardiac Arrest(sudden stop of the heart) or for Open heart surgery(CABG) is the obstruction of blood vessels(arteries) supplying the heart with oxygen.

    Without sufficient oxygen supply the heart can’t function properly and therefore a heart attack or a cardiac arrest occurs and Open heart surgery(CABG) to replace some of the blocked vessels that supply the heart with oxygen may be necessary.

    After the heart attack, cardiac arrest or open heart surgery has occurred and an Echoecardiogram or an Angiogram(screening of the major blood vessels supplying the heart with oxygen) may have been performed, as well as Cardiac output measurements may be performed and after the weakness of the heart has been confirmed the Intra-aortic-balloon pump(IABP) may be inserted. The Intra-aortic-balloon pump(IABP) often goes hand in hand with Inotropic therapy for low blood pressure(hypotension).

    Intra-aortic balloon pump(IABP) is only a short-term solution

    The Intra-aortic-balloon pump(IABP) is a short term and temporary solution to support a severely weak heart after Cardiac Surgery(Coronary Artery Bypass Graft (CABG)), after a Heart Attack(Acute Myocardial Infarction) or after a Cardiac Arrest has been sustained. It will only be used for a few days, up to one week in rare instances. The longer the Intra-aortic-balloon pump(IABP)  stays in place the higher the risk for infection, as the Intra-aortic-balloon pump(IABP) enters one of the major arteries through the groin and then sits in front of the heart and supports fresh oxygenated blood supply to the heart in order to improve the contractions of the heart.

    Sometimes the Intra-aortic-balloon pump(IABP) stays in for up to one week and in rare instances I have seen it staying in for up to two weeks, therefore increasing the risk of infection.

    Also, if the Intra-aortic-balloon pump(IABP) is showing to be ineffective and the heart muscle’s contractility is not improving it may well be a sign that more and different therapy is required to get your critically ill loved one’s heart on the way to recovery.

    Other measures after Intra-aortic-balloon pump(IABP) could be

    Intra-aortic-balloon pump(IABP) therapy in Intensive Care often goes hand in hand with mechanical ventilation and an induced coma.

    Sometimes Intra-aortic-balloon pump(IABP) therapy is taking place outside of Intensive Care, mainly in Coronary Care Units where ventilation and an induced coma is not part of your loved one’s treatment.

    In any case, if your loved one is critically ill in Intensive Care and has been placed on an Intra-aortic-balloon pump(IABP) chances are that you are out of your comfort zone and that you feel stressed, vulnerable, frustrated and overwhelmed by the experience of having your loved one critically ill in Intensive Care!

    It’s good that you are seeking help and independent advice, because unless you have done your own research you should always question the Intensive Care team’s approach, because if you don’t question, you have no power, control and influence! The consequence then is that the Intensive Care team can drive their own agenda and their agenda may not be in the best interest of your critically ill loved one and your Family.

    I have learned this in more than 15 years Intensive Care nursing experience whilst working in three different countries around the world! You’d be surprised of how much goes on behind the scenes with the only purpose to keep you and your Family at arms length and the Intensive Care team has no interest in letting you see behind the scenes and they don’t want you to have control, power and influence!

     How do you get to that all important feeling of control, power and influence whilst your loved one is critically ill in Intensive Care?

    You’ll get the important feeling of control, power and influence by downloading your FREE “INSTANT IMPACT” Report by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions

    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying

    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation

    • you’ll get crucial ‘behind the scenes’ insight so that you understand what is really happening in Intensive Care

    Thank you for tuning into this week’s “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely,
    your Friend
    Patrik Hutzel

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    How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP) in Intensive Care? is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/long-can-critically-ill-loved-one-stay-intra-aortic-balloon-pumpiabp/feed/ 0 http://youtu.be/Km3dlWZz7iY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+my+critically+ill+loved+one+stay+on+an+Intra-aortic+balloon+pump(IABP)-.mp3 - Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , http://youtu.be/Km3dlWZz7iY https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+long+can+my+critically+ill+loved+one+stay+on+an+Intra-aortic+balloon+pump(IABP)-.mp3 Hi, it’s Patrik Hutzel from www.intensivecarehotline.com... intensiv yes
    The 5 reasons why you need to be DIFFICULT and DEMANDING when your loved one is critically ill in Intensive Care http://intensivecarehotline.com/5-reasons-need-difficult-demanding-loved-one-critically-ill-intensive-care/ http://intensivecarehotline.com/5-reasons-need-difficult-demanding-loved-one-critically-ill-intensive-care/#comments Mon, 02 Dec 2013 00:03:33 +0000 http://intensivecarehotline.com/?p=4248 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+reasons+why+you+need+to+be+difficult%26demanding+if+your+loved+one+is+critically+ill+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I showed you “The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment!” and if you haven’t read, watched or listened to the update, you can check it out here.

    In this week’s blog I want to talk about “The 5 reasons why you need to be difficult and demanding when your loved one is critically ill in Intensive Care!”

    If you have found yourself in the situation that your loved one is critically ill in Intensive Care, you have probably found yourself in a difficult and challenging situation. You have probably also found that other people(the Intensive Care team) are driving the bus and you probably feel like you have no or little control, power and influence about the decisions that the Intensive Care team is making.

    Those decisions may or may not be in the best interest of your critically ill loved one. You probably feel very vulnerable and you may struggle, feel overwhelmed and you’re probably frustrated by the situation that you, your Family and your critically ill loved one are in.

    More importantly, depending on the diagnosis and prognosis of your critically ill loved one, you may have found that the Intensive Care team may paint a pretty grim “doom and gloom” picture of your critically ill loved one’s situation and you may feel like its all negative. Overall, it appears to be a one- sided coin with the Intensive Care team holding all the power…
    It’s not a very good position to be in and you should always contemplate what’s behind the Intensive Care team’s positioning.

    Why you need to be difficult and demanding

    Even more important, you need to start being difficult and demanding whilst your loved one is critically ill in Intensive Care, because if you’re not, your critically ill loved one may actually not receive the best of treatment and care. It could even be worse and if your loved one is in a really difficult, life threatening situation or is a long-term Patient in Intensive Care, the Intensive Care team may position your loved one’s prognosis and diagnosis as a situation where they suggest to “withdraw treatment”, “withdraw life support” or they start talking about “futility of treatment”. If it has come to that point, it may already be too late and that’s why it’s so important that you and your family are difficult and demanding from the start, when your loved one is critically ill in Intensive Care.

    Why you need to go against the grain

    It sounds counterintuitive and it sounds like you need to go against the grain, when you’re difficult and demanding whilst your loved one is critically ill in Intensive Care.
    The reality is that if you’re not difficult and demanding you are like 99% of Families of critically ill Patients in Intensive Care who don’t position themselves correctly and those Families have no influence, no power and no control and those Families and their critically ill loved one are at the mercy of the Intensive Care team.

    Who do you want to be? The choice is yours…

    You certainly don’t want to be one of those Families. You want to be a Family who has control, power and influence. The minute you start becoming difficult and demanding that’s the time when the dynamics shift in your favour! Therefore, I’ll give you “The 5 reasons why you need to be difficult and demanding when your loved one is critically ill in Intensive Care”. Let’s look at those 5 reasons in detail.

    1. Most Families of critically ill Patients in Intensive Care put the Intensive Care team on a pedestal and they think the Intensive Care team is “superior” to them

    It’s a shame that almost 99% of the Families of critically ill Patients in Intensive Care put the doctors and the nurses in Intensive Care on a “pedestal” so to speak and they therefore think that the doctors and the nurses are “superior” to them. Those Families hand their power over on a platter and they’ll never be influential, have power and control over their critically ill loved one’s destiny. You need to stop doing that and you need to become difficult and demanding and you need to start asking the right questions now!

    2. The Intensive Care team and the Intensive Care Unit have their own agenda and their own-often negative positioning, especially in difficult, time and resource intensive treatments for your critically ill loved one

    You really need to understand how an Intensive Care unit operates on a psychological level, because if you’re not, the Intensive Care team might walk all over you, especially if a prolonged treatment of your critically ill loved one is on the horizon.
    The Intensive Care team may not have an interest in going through a lengthy, difficult and resource intensive treatment for your critically ill loved one and save their life. The Intensive Care team therefore may position your loved one’s prognosis and diagnosis in a very negative light and they may suggest to “stop or limit treatment”, because they don’t want to invest the time, the money and other resources into your critically ill loved one’s treatment.
    You need to know and understand the moving parts of an Intensive Care Unit in order to counteract the Intensive Care team’s positioning and you can do so by reading our blog, get access to your FREE “INSTANT IMPACT” Report at the end of this blog and you can do so by being difficult and demanding!

    3. If you’re not difficult and demanding whilst your loved one is critically ill in Intensive Care, you’ll never find out the truth about your critically ill loved one’s situation

    Especially if your critically ill loved one is in a life threatening situation or in a situation where he or she is expected to be in Intensive Care for long periods of time, you and your Family need to be difficult and demanding! You want to know exactly what is going on and you only find out what is really going on, if you are asking the right questions and if you are difficult and demanding. Families of critically ill Patients in Intensive Care who aren’t difficult and demanding are always getting the short straw and if you’re not asking the right questions, your critically ill loved one may miss out on life saving treatment and life saving care. You can also get more information about what to do if your critically ill loved one is a long-term Patient in Intensive Care or is facing treatment limitations by clicking on this link below.
    “Follow this proven 5 step process on how to be in control and influential if your loved one is a long-term Patient in Intensive Care or is facing treatment limitations in Intensive Care”

    4. You need to be difficult and demanding because the Intensive Care team are like “Fish in water” and you and your Family are like “Fish out of water”

    The Intensive Care team is living and breathing Intensive Care every single day and they are like “Fish in water”. You and your Family on the other hand are like “Fish out of water” and most Families are completely out of their comfort zone. The Intensive Care team are most of the time in their comfort zone. They therefore often don’t even contemplate the questions you want to know, let alone take those questions seriously. They often also have the attitude of talking over you, rather than entering into a proper dialogue and discussion. Often, the Intensive Care team thinks they “know what’s best” and they therefore don’t really want to know your opinion. But that’s why it’s even more important that you’re difficult and demanding and that you’re asking the right questions!

    5. You need to be difficult and demanding because it leverages your control, power and your level of influence

    Again, as I mentioned earlier, if you’re not difficult and demanding, you’ll never have control, power and influence. If on the other hand you’ll get informed and learn what questions you need to ask, you become difficult and demanding and that’s when the power dynamics change and shift in your favour.

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely, your Friend
    Patrik Hutzel

    The 5 reasons why you need to be DIFFICULT and DEMANDING when your loved one is critically ill in Intensive Care is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/5-reasons-need-difficult-demanding-loved-one-critically-ill-intensive-care/feed/ 0 http://youtu.be/sBR7U7P1g-Y https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+reasons+why+you+need+to+be+difficult%26demanding+if+your+loved+one+is+critically+ill+in+ICU.mp3 - Hi, http://youtu.be/sBR7U7P1g-Y https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+reasons+why+you+need+to+be+difficult%26demanding+if+your+loved+one+is+critically+ill+in+ICU.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREH... intensiv yes
    Nelson Mandela is receiving Intensive Care treatment in his home! http://intensivecarehotline.com/nelson-mandela-receiving-intensive-care-treatment-home/ http://intensivecarehotline.com/nelson-mandela-receiving-intensive-care-treatment-home/#comments Sat, 30 Nov 2013 03:53:52 +0000 http://intensivecarehotline.com/?p=5203 https://s3-ap-southeast-2.amazonaws.com/intensivecareathome.com.au/Nelson+Mandela.mp3 This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive […]

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    This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au

    Hi it’s Patrik Hutzel from INTENSIVECAREATHOME.COM.AU where we help long-term ventilated Adults& Children with Tracheostomy to improve their Quality of life and where we also help hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!

    In last week’s blog I was asking the question “INTENSIVE CARE AT HOME is it evidence based?” and I gave some answers and evidence. If you haven’t read the blog you can access it here. http://intensivecareathome.com.au/intensive-care-home-evidence-based/

    In this week’s blog I want to pick up a story that has received world wide media attention and has made headlines in recent months. Many of us would have heard that “Nelson Mandela is receiving Intensive Care treatment in his home!”

    The former President of South Africa and 1993 recipient of the Nobel peace prize has been discharged from Intensive Care and he has been receiving Intensive Care treatment in his home since September this year, after a nearly three month stay in Intensive Care for Pneumonia, prior to his discharge home. His Intensive Care treatment at home has been featured in many media outlets around the world in recent months.

    One media outlet has cited “The government has largely refused to give details about Mandela’s condition, citing the need for privacy, but said “he continues to recover”.

    One of Nelson Mandela’s grandson’s reported “He is still progressing steadily but very much under a critical condition.”

    Whilst his full medical condition remains undisclosed, it’s very likely that he has a Tracheostomy, as Mandela’s former wife Winnie Madikizela-Mandela this week told a local newspaper that he remains “quite ill” and is unable to speak because of tubes being used to clear his lungs of liquid. The bedroom in his home is like an ICU ward.”

    I have put links to some media articles at the end of the blog.

    Nelson Mandela has been a strong proponent, fighter and advocate for human rights, peace and he has been an anti-apartheid revolutionary in his home country and now he appears to be the first prominent person who receives Intensive Care in the Home treatment that receives worldwide media attention! Nelson Mandela has always been a “moral authority” with a great concern “for truth”. He has been a great driver and implementer of change.

    Even in his final days, he appears to be advocating for change that could affect many people in the future in the health care sector as an advocate for Home Care, despite being critically ill!

    There are clear indicators that with an ageing population, Intensive Care beds being expensive and scarce, and with Hospital waiting lists growing, INTENSIVE CARE AT HOME treatment is becoming a reality and an accepted model of care!

    What are your thoughts? Do you think Nelson Mandela’s Intensive Care at Home’s treatment is a good indicator for change in practice? Leave your comments on the blog here.

    If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply reply send me an email to patrik@intensivecareathome.com.au

    This is Patrik Hutzel from INTENSIVECAREATHOME.COM.AU and I’ll see you again in another update next week.

     

     

    Nelson Mandela is receiving Intensive Care treatment in his home! is a post from: INTENSIVE CARE HOTLINE

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    What could be the cause if my critically ill loved one is REMOVED from an induced coma but still hasn’t woken up? http://intensivecarehotline.com/what-could-be-the-cause-if-my-critically-ill-loved-one-is-removed-from-an-induced-coma-but-still-hasnt-woken-up/ http://intensivecarehotline.com/what-could-be-the-cause-if-my-critically-ill-loved-one-is-removed-from-an-induced-coma-but-still-hasnt-woken-up/#comments Tue, 26 Nov 2013 01:11:00 +0000 http://intensivecarehotline.com/?p=4126 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Delay-in-waking-up-induced-coma.mp3 Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

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    Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained “How many blood tests should my critically ill loved one have in Intensive Care per day?” If you haven’t read it, you can check it out here.

    In this week’s episode of your questions answered I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question that I want to answer this week is What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up?”

    Many critically ill Patients in Intensive Care, mainly if they have been admitted to Intensive Care after surgery, after accidents and/or if they require a breathing tube(endotracheal tube) for mechanical ventilation for their critical illness have been placed in an induced coma (What is an induced coma and why is my critically ill loved one in an induced coma? http://intensivecarehotline.com/induced-coma-critically-ill-loved-one-induced-coma/).

    The induced coma serves a specific purpose

    The induced coma or artificial coma means that your critically ill loved one is getting intravenous drugs(sedatives such as Propofol or Midazolam and opiates such as Morphine and Fentanyl) that keep your loved one in a deep sleep so that

    • most body functions are kept at a minimum to not stress the body and your loved one
    • Tolerate the breathing tube(endotracheal tube) in your loved one’s throat and the mechanical ventilation as they couldn’t tolerate the breathing tube without the induced coma and without the sedation
    • Your critically ill loved one’s body has time to recover and heal from surgery, accidents, head injury etc…

    In any case, if your critically ill loved one requires mechanical ventilation and a breathing tube he or she will need to be induced in a coma temporarily.

    Once the time is right, your loved one will be removed from the induced coma

    If, however the time comes for your critically ill loved one to be removed or woken up from the induced coma there could be a delayed process for your critically ill loved one to actually wake up and come out of the induced coma.

    If all the sedative drugs(such as Propofol and Midazolam) and opiate drugs(such as Morphine and Fentanyl) for the induced coma have either been completely switched off or have been significantly reduced so that your critically ill loved one should wake up in order to be taken off the ventilator and breathe by themselves and you find that there is a significant delay in your critically ill loved one waking up, after your loved one has been taken off the sedative and opiate drugs there is generally no reason to panic. Several other reasons and factors may delay for your loved one to “wake up” and come out of the induced coma. So let’s look at those reasons that may delay for your loved one to “wake up” and come out of the induced coma

    • Your critically ill loved one has too many sedative and opiate drugs in their body system and therefore those drugs have accumulated and delay for your loved one to “wake up”. Once the body has gotten rid of those excess sedative and opiate drugs your loved one will wake up if there are no other reasons that keep your loved one in the coma
    • Your critically ill loved one has kidney or liver abnormalities that stop the body from clearing all the sedative and opiate drugs that are ‘floating’ in your loved one’s body system. Both organs, the kidney and the liver are responsible to not only process the drugs, but also to ‘get rid of the drugs’ after they have been in the body system
    • Studies have found that with increasing age, it takes longer for a critically ill Patient to come out of an induced coma. As a rule of thumb, if your critically ill loved one is above the age of 60- 70, there can be a delay to come out of the induced coma
    • Again, as a rule of thumb, the longer your critically ill loved one has been placed in an induced coma, the likelihood of a delayed and slower waking up process is increasing. You and your Family might have to be Patient

    Not enough oxygen supply to the brain could mean there is a delay as well

    In some instances, especially if the Intensive Care team suspects that your critically ill loved one may not have had sufficient oxygen supply to their brain for a prolonged period of time, there could be a delay for your loved one to “wake up” from the induced coma as well  What is the prognosis after my critically ill loved one’s brain has not had sufficient oxygen supply(hypoxic brain injury)? http://intensivecarehotline.com/prognosis-critically-ill-loved-ones-brain-sufficient-oxygen-supplyhypoxic-brain-injury/

    In any case, the most important thing for you to know is that you need to be Patient if your loved one is critically ill in Intensive Care, especially if they’re not waking up after the induced coma. The reality is that your critically ill loved one will recover and wake up in his or her own time.

    You and your Family always need to make up your own mind

    It’s also extremely important that you and your Family make up your own mind whilst your loved one is critically ill in Intensive Care  Why you must make up your own mind about your critically ill loved one’s situation in Intensive Care even if you’re not a doctor or a nurse! http://intensivecarehotline.com/must-make-mind-critically-ill-loved-ones-situation-intensive-care-even-youre-doctor-nurse/

    The last thing you want is to be at the mercy of the Intensive Care team and you want to have as much control, power and influence whilst your loved one is critically ill in Intensive Care.

    How do you get to that all important feeling of control, power and influence whilst your loved one is critically ill in Intensive Care?

    You’ll get the important feeling of control, power and influence by downloading your FREE “INSTANT IMPACT” Report by entering your email below NOW!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions

    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying

    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation

    • you’ll get crucial ‘behind the scenes’ insight so that you understand what is really happening in Intensive Care

    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s your questions answered and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!

    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely,
    your Friend
    Patrik Hutzel

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    What could be the cause if my critically ill loved one is REMOVED from an induced coma but still hasn’t woken up? is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/what-could-be-the-cause-if-my-critically-ill-loved-one-is-removed-from-an-induced-coma-but-still-hasnt-woken-up/feed/ 0 http://youtu.be/L74eiJbJTsM https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Delay-in-waking-up-induced-coma.mp3 - Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families o... http://youtu.be/L74eiJbJTsM https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/Delay-in-waking-up-induced-coma.mp3 Hi, it’s Patrik Hutzel from www.intensivecarehotline.com (http://www.intensivecarehotline.com/) , where we in... intensiv yes
    The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”! http://intensivecarehotline.com/5-questions-need-ask-intensive-care-team-talking-futility-treatment-withdrawal-life-support-withdrawal-trea/ http://intensivecarehotline.com/5-questions-need-ask-intensive-care-team-talking-futility-treatment-withdrawal-life-support-withdrawal-trea/#comments Mon, 25 Nov 2013 09:14:10 +0000 http://intensivecarehotline.com/?p=4115 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+questions+you+need+to+ask+when+the+Intensive+Care+team+is+talking+about++Futility+of+treatment+.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I […]

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    Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    In last week’s blog I showed you “The 5 reasons why you need to stop being intimidated by the Intensive Care team, if your loved one is critically ill in Intensive Careand if you haven’t read, watched or listened to the update, you can check it out here.

    In this week’s blog I want to talk about “The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”!

    No other situation or topic in Intensive Care is causing more emotion, discomfort, angst, controversy and irritation than end of life situations and/or the situations and discussions that lead up to it- And rightly so, because life is extremely precious. More importantly, you need to be highly sensitised and alert whenever the Intensive Care is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”, especially when it relates to your critically ill loved one’s treatment.

    After more than 15 years Intensive Care nursing experience in three different countries, I have been involved in many end of life situations and I have seen many situations where the Intensive Care team has positioned critically ill Patients’ prognosis, diagnosis and their ongoing treatment as “futile”.

    Futility of treatment is also defined as “justification of a decision not to pursue certain and ongoing medical treatment that may be requested or demanded by Patients or their surrogates”.

    “Withdrawal of life support” and “Withdrawal of treatment” are in the same category than “Futility of treatment” and the reality in Intensive Care is that the difference between the three statements is negligible and grey, as they all have the same end goal in mind, which is basically not to extend treatment and let a Patient approach their end of life and die. And this may well be in the best interest of a critically ill Patient and a Family.

    However, in many cases “Futility of treatment”, “Withdrawal of life support” and/or “Withdrawal of treatment” are strong statements to make by the Intensive Care team and you need to know and understand why the Intensive Care team positions your critically ill loved one’s prognosis and diagnosis that way and how this positioning may impact on the course of your, your Family’s and most importantly your critically ill loved one’s trajectory of their stay in Intensive Care.

    You need to know where you stand, irrespective of the Intensive Care team’s positioning!

    You also need to have your and your Family’s positioning worked out when entering those discussions, because otherwise the Intensive Care team will make decisions for you and for your critically ill loved one if you come unprepared and the Intensive Care team will walk all over you and make decisions that suits the Intensive Care Unit’s needs and not your and your critically ill loved one’s needs.

    Your positioning during those discussions is so important that I can’t stress enough that the Intensive Care team is prepared to “pull the plug” on your critically ill loved one, if you don’t have your “act together” so to speak. After all, you, your Family and your critically ill loved one are in a unique and often “once in a lifetime situation” that is defining the rest of your life. Therefore you want to have as much information, support and education available that gets you through this difficult situation.

    Putting your emotions aside for a moment is crucial!

    Whenever you’re faced with a challenge like end of life in Intensive Care there are a multitude of questions you need to ask and it’s important that you approach this topic rationally and that you put your emotions aside for a moment.

    Most importantly, after having been involved in many end- of life situations in Intensive Care, I have found that you need to ask 5 distinct questions regarding the positioning of the Intensive Care team, as it relates to “Futility of treatment”, “Withdrawal of life support” and/or “Withdrawal of treatment” in your critically ill loved one’s situation. Because as it relates to other areas in life as well, in order to find the right answers you need to ask the right questions!

    1.       Does your critically ill loved one’s treatment cost too much time, money and resources that the Intensive Care team doesn’t want to invest?

    Intensive Care is a place that is resource intensive and one day in Intensive Care costs $ 3,000- $ 5,000 per day(£ 2,000- £3,000 per day in the UK). Therefore, besides the clinical condition and prognosis of your critically ill loved one, the Intensive Care team is looking at your critically ill loved one’s condition and prognosis as a “business case” and will position your loved one’s case accordingly. Imagine your loved one being in ICU with severe head injuries and a recovery might only be possible after many weeks in Intensive Care, would it be easier for the Intensive Care team to say that “treatment is futile” and that they would therefore “withdraw treatment” or “withdraw life support” for obvious reasons?

    2.       Are there other admissions awaiting treatment in Intensive Care and are they competing for scarce and expensive Intensive Care beds?

    Beds and staff in Intensive Care are limited in numbers and they tend to be in high demand. If a Patient gets discharged, the next Patient is generally not far away and a bed in ICU never really gets ‘cold’.

    What if your critically ill loved one is in an already fully occupied Intensive Care Unit and the Intensive Care team knows that in the next few days they will be overstretching their capacity. The Intensive Care team knows that they have many Patients within the Hospital awaiting surgery and some of  those Patients therefore need a bed in Intensive Care. If they don’t empty some of the beds they will have disgruntled Patients, disgruntled Surgeons, Anaesthetists and a disgruntled Hospital administration. Therefore, often the easiest way out of the dilemma is to “sell” to you and your Family that the treatment of your critically ill loved one is “futile”. Again, you need to be highly aware and sensitive about those moving parts in Intensive Care, because if you’re not, the Intensive Care team might let your loved one die.

    3.       Does the Intensive Care team has a limited mindset and doesn’t believe in the recovery and the treatment of your critically ill loved one?

    A limited or an abundant mindset can make a big difference in Intensive Care. If the Intensive Care team has a limited mindset and doesn’t believe that your critically ill loved one will recover, it’s a big challenge and something that can be turned around by your and by your Family’s positioning. Often Intensive Care Unit’s with a limited mindset also have a negative culture within. They also tend to have negative outlooks and if you and your Family find yourself in such a limiting and inhibiting culture and mindset, your job is to challenge it and ask for what you want.

    Many Intensive Care Unit’s have a positive culture and also abundant mindsets and they therefore are optimistic in their outlooks.

    I have written a blog about culture in Intensive Care and how it impacts on your critically ill loved one’s treatment  http://intensivecarehotline.com/what-the-doctors-and-the-nurses-behaviour-in-intensive-care-is-telling-you-about-the-culture-in-a-unit/

    4.       Does the Intensive Care team think it’s “sexy” to continue treating your critically ill loved one?

    I know that this is a strong statement to make. and I make it anyway. You must know that in some Intensive Care Unit’s the latest technology that can save somebody’s life such as ECMO, Balloon pump(IABP), High frequency oscillation ventilation and many other of the latest technologies that may be used for your critically ill loved one’s recovery might be of interest for the Intensive Care team to use, as it’s perceived as “sexy” and interesting and it gets people excited. If none of these treatments or equipment is available or perceived as an option, again the Intensive Care team may position your critically ill loved one’s treatment as “futile”.

    5.       Does the Intensive Care team perceive you and your Family as weak or strong and do they think you have any knowledge about the Intensive Care environment?

    This is another very important question you need to ask yourself and you need to have an awareness whether you and your Family are perceived as weak or strong by the Intensive Care team. If the Intensive Care team thinks that you and your Family take everything for Face Value and that you don’t question, your improving the likelihood that the Intensive Care team suggests to you and your Family “to withdraw treatment” or “to withdraw life support” and you have no control, power and influence.

    If on the other hand, you and your Family are perceived as strong, knowledgeable, powerful and influential you are taking matters in your own hands and you are able to have control, influence and power.

    How you can get to control, power, impact and influence
    If you want to have control, power and influence whilst your loved one is critically ill in Intensive Care and if you want to be perceived as strong, influential, impactful and knowledgeable by the Intensive Care team and if you want to be in control of your and your critically ill loved one’s destiny and if you want to make an impact, download your FREE “INSTANT IMPACT” REPORT NOW by entering your email below!

    In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!

    In your FREE report you’ll also discover
    • how to ask the doctors and the nurses the right questions
    • how to eliminate fear, frustration, stress, struggle and vulnerability
    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
    • you’ll get crucial ‘behind the scenes’ insight so that you understand what is really happening
    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    Thank you for tuning into this week’s update and I hope that this episode has helped you how you can change the Intensive Care team’s perception about you and I’ll see you again in another update next week! Make sure you also check out our ”your questions answered” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!
    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely,
    your Friend
    Patrik Hutzel

    Related Articles:

    The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”! is a post from: INTENSIVE CARE HOTLINE

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    http://intensivecarehotline.com/5-questions-need-ask-intensive-care-team-talking-futility-treatment-withdrawal-life-support-withdrawal-trea/feed/ 0 http://youtu.be/27e5awkQBl4 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+questions+you+need+to+ask+when+the+Intensive+Care+team+is+talking+about++Futility+of+treatment+.mp3 - Hi, http://youtu.be/27e5awkQBl4 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com/2014+blog+feed/5+questions+you+need+to+ask+when+the+Intensive+Care+team+is+talking+about++Futility+of+treatment+.mp3 Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM (http://intensivecarehotline.com/) , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! In last week’s blog I showed you “The 5 reasons why you need to stop being intimidated by the Intensive Care team, if your loved one is critically ill in Intensive Care (http://intensivecarehotline.com/5-reasons-need-stop-intimidated-intensive-care-team-loved-one-critically-ill-intensive-care/)” and if you haven’t read, watched or listened to the update, you can check it out here. In this week’s blog I want to talk about “The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”! No other situation or topic in Intensive Care is causing more emotion, discomfort, angst, controversy and irritation than end of life situations and/or the situations and discussions that lead up to it- And rightly so, because life is extremely precious. More importantly, you need to be highly sensitised and alert whenever the Intensive Care is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”, especially when it relates to your critically ill loved one’s treatment. After more than 15 years Intensive Care nursing experience in three different countries, I have been involved in many end of life situations and I have seen many situations where the Intensive Care team has positioned critically ill Patients’ prognosis, diagnosis and their ongoing treatment as “futile”. Futility of treatment is also defined as “justification of a decision not to pursue certain and ongoing medical treatment that may be requested or demanded by Patients or their surrogates”. “Withdrawal of life support” and “Withdrawal of treatment” are in the same category than “Futility of treatment” and the reality in Intensive Care is that the difference between the three statements is negligible and grey, as they all have the same end goal in mind, which is basically not to extend treatment and let a Patient approach their end of life and die. And this may well be in the best interest of a critically ill Patient and a Family. However, in many cases “Futility of treatment”, “Withdrawal of life support” and/or “Withdrawal of treatment” are strong statements to make by the Intensive Care team and you need to know and understand why the Intensive Care team positions your critically ill loved one’s prognosis and diagnosis that way and how this positioning may impact on the course of your, your Family’s and most importantly your critically ill loved one’s trajectory of their stay in Intensive Care. You need to know where you stand, irrespective of the Intensive Care team's positioning! You also need to have your and your Family’s positioning worked out when entering those discussions, because otherwise the Intensive Care team will make decisions for you and for your critically ill loved one if you come unprepared and the Intensive Care team will walk all over you and make decisions that suits the Intensive Care Unit’s needs and not your and your critically ill loved one’s needs. Your positioning during those discussions is so important that I can’t stress enough that the Intensive Care team is prepared to “pull the plug” on your critically ill loved one, if you don’t have your “act together” so to speak. After all, you, your Family and your critically ill loved one are in a unique and often “once in a lifetime situation” that is defining the rest of your life. intensiv yes
    INTENSIVE CARE AT HOME is it evidence based? http://intensivecarehotline.com/intensive-care-home-evidence-based/ http://intensivecarehotline.com/intensive-care-home-evidence-based/#comments Tue, 19 Nov 2013 03:42:45 +0000 http://intensivecarehotline.com/?p=5200 https://s3-ap-southeast-2.amazonaws.com/intensivecareathome.com.au/Evidence+based+INTENSIVE+CARE+AT+HOME.mp3 This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! […]

    INTENSIVE CARE AT HOME is it evidence based? is a post from: INTENSIVE CARE HOTLINE

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    This blog post was first published at our sister site INTENSIVE CARE AT HOME, a specialized Intensive Home Care nursing service, focused on Quality of life and/or Quality of end of life for long-term mechanically ventilated Adults& Children with Tracheostomy. The Home Care service provides a genuine alternative to a long-term stay in Intensive Care! For more information visit www.intensivecareathome.com.au

    Hi it’s Patrik from INTENSIVECAREATHOME.COM.AU where we help long-term ventilated Adults& Children with Tracheostomy to improve their Quality of life and where we also help hospitals and Intensive Care Units to save money and resources, whilst providing Quality Care!

    In last week’s blog I was talking about “We can’t always cure long-term ventilated Adults& Children with Tracheostomy, but we can always care for our Clients’ Quality of Life and/or their Quality of-end-of-Life”. You can check it out here here.

    In this week’s blog I want to answer a question that I have been asked by many people who are interested in the concept of Intensive Home Care nursing for long-term ventilated Adults& Children with Tracheostomy and the question is “INTENSIVE CARE AT HOME is it evidence based?”

    It’s a great question to ask and especially in this day and age, where transparency is paramount and easily achieved with the help of the Internet, all I can say is that a lot of research and even more importantly, field experience has been gained in countries where Intensive Home Care services for long-term ventilated Adults& Children with Tracheostomy have been a successful reality for the last 15 years.

    For example the “Guidelines for Non-Invasive and Invasive mechanical ventilation for treatment of chronic respiratory failure” have been issued by the German Society for Pulmonolgy in 2010 and those guidelines are up to date and current and they also present what is the best evidence based option for long-term ventilated Adult or Child with Tracheostomy. And that option is not a long-term stay in Intensive Care and the only option for long-term ventilated Adults& Children with Tracheostomy is Home. Those EVIDENCE BASED guidelines are accessible on our website here

    Those guidelines have been derived from now 15 years of mechanical home ventilation for long-term ventilated Adults& Children with Tracheostomy as a genuine alternative to a long-term stay in Intensive Care. Services have been exclusively delivered by specialised Intensive Home Care nursing services.
    The guidelines are evidence based and you can find the references at the end of the guidelines.

    The option for long-term ventilated Adults& Children with Tracheostomy to go home with specialised and designated Intensive Home Care nursing services was born out of necessity to improve the Quality of Life for long-term ventilated Adults& Children with Tracheostomy and their Families and also to free expensive and scarce Intensive Care beds and therefore minimise expenses and cut down surgical and medical waiting lists. A much needed win-win situation!

    Therefore Intensive Home Care nursing services have been massively successful in many European countries and in many parts of the USA, with not only drastic positive benefits for long-term ventilated Adults& Children with Tracheostomy and their Families in regards to their improved Quality of Life and/or Quality of-end-of-Life. The benefits for the health system and for Intensive Care Units in particular are obvious and they include and are not limited to
    • Having an empty ICU bed that can be used for more acutely ill Patients that occupy ICU beds for shorter periods
    • Having a more satisfied nursing and medical workforce who is getting excited by looking after more acutely unwell Intensive Care Patients
    • Reallocation of resources targeted towards higher acuity ICU care
    • Reduced hospital waiting lists(surgical and/or medical)
    • Admit Patients to Intensive Care within the 4 hour rule from Emergency Departments
    • Save expensive Overtime, Casual or Agency rates for nursing staff used for a long-term Patient that can be in a different, more Patient and Family focused environment

    What are your thoughts and experiences? Leave your comments on the blog here.

    If you want to discuss your needs and how we can help your Intensive Care Unit and your long-term ventilated Patients and their Families and if your organisation wants to free up ICU beds or if you simply have any questions, give me a call on 041 094 2230 or simply reply to this email.
    This is Patrik Hutzel from INTENSIVECAREATHOME.COM.AU and I’ll see you again in another update next week.

     

    INTENSIVE CARE AT HOME is it evidence based? is a post from: INTENSIVE CARE HOTLINE

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    How many blood tests should my critically ill loved one have in Intensive Care per day? http://intensivecarehotline.com/many-blood-tests-critically-ill-loved-one-intensive-care-per-day/ http://intensivecarehotline.com/many-blood-tests-critically-ill-loved-one-intensive-care-per-day/#comments Mon, 18 Nov 2013 22:03:36 +0000 http://intensivecarehotline.com/?p=3965 https://s3-ap-southeast-2.amazonaws.com/intensivecarehotline.com.questions/How+many+blood+tests+should+my+critically+ill+loved+one+have+in+Intensive+Care+per+day-.mp3 Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care! This is another […]

    How many blood tests should my critically ill loved one have in Intensive Care per day? is a post from: INTENSIVE CARE HOTLINE

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    Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in Intensive Care!

    This is another episode of “your questions answered” and in last week’s episode I explained If my critically ill loved one has a breathing tube(endotracheal tube) do they need a chest x-ray daily?If you haven’t read it, you can check it out here.

    In this week’s episode of your questions answered I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question that I want to answer this week is “How many blood tests should my critically ill loved one have in Intensive Care per day?”

    This is actually a great question to ask, especially if your critically ill loved one is not falling under a government healthcare scheme and is privately insured or if you and your Family are self paying for your critically ill loved one’s treatment!

    In any case, you want to know how many blood tests your critically ill loved one needs in a day, because knowledge is power and it’s always good and useful to have insights into the world of Intensive Care, especially if you are not a doctor or a nurse! The more you know, the more power, influence and the more control you have about the destiny of your critically ill loved one and the more knowledge you have about critical illness in Intensive Care, the more in control you are and the less dependent you are that the Intensive Care team is making decisions that may or may not be in the best interest of your critically ill loved one!

    Here’s what you need to know

    As a rule of thumb critically ill Patients in Intensive Care have a full screening of their blood when they’re first admitted to Intensive Care and then they shouldn’t require blood tests more than once a day. This once daily blood tests are usually done in the early morning hours, usually between 4am to 7am. You will find more detailed information about Pathology(blood) tests in Intensive Care here http://intensivecarehotline.com/blood-pathology-tests-in-intensive-care/

    Those blood tests are sent to the Pathology Laboratory and the results usually come back within a few hours.

    There are exceptions to the rule in emergency situations

    Of course there’s always the exception to the rule and you should know that if your critically ill loved one is in an emergency situation and extremely critically ill, you need to know that blood tests may be done more often than once a day and they may be done whenever the Intensive Care team needs to know things such as

    • Haemoglobin(red blood cells in the blood, which is an indicator for bleeding if the number is low)
    • Clotting factors(Coagulation) such as APTT, INR and Platelets to know whether the blood is too thick or too thin and therefore may cause bleeding(blood too thin) or clotting(blood too thick)
    • White cell count and blood cultures if the Intensive Care team suspects an infection, as both tests will indicate whether your critically ill loved one has an infection
    • Cardiac(Heart) markers such as Troponin and CK to indicate whether a Cardiac(Heart) event such as a heart attack has taken place

    There are more blood tests done all day around in Intensive Care and here’s why

    Even though, the routine blood tests are done once daily in the early morning hours to get a full screening of your critically loved one’s blood, generally speaking there are more and ongoing blood tests performed 24/7 in Intensive Care to address and assess the effectiveness of ongoing treatment of your critically ill loved one. This is especially important if your critically ill loved one is mechanically ventilated and has a breathing(endotracheal) tube. Therefore a regular and ongoing assessment of your loved one’s arterial blood gases(ABG’s) is necessary. Your critically ill loved one is therefore having an Arterial Line inserted in either their wrist or their groin. It’s therefore easy and painless for the bedside nurse to take a blood sample and get an immediate result that will tell the Intensive Care team whether

    • The ventilation therapy is effective as it indicates oxygenation levels in the blood and it also reads Carbon dioxide levels in the blood. Therefore ABG’s are regularly done before intubation and extubation to assess the effectiveness of your critically ill loved one’s breathing
    • The ABG reading also shows results about Electrolytes in the blood such as Potassium, Sodium, Calcium- Electrolyte readings are important to know to maintain a healthy equilibrium in the blood for a normal heart function as abnormal Electrolytes can disturb normal heart function
    • The ABG furthermore checks Blood sugar levels and they can often be abnormal in Intensive Care even though your critically ill loved one is not a Diabetic(blood sugar levels tend to be high in Intensive Care due to the stress response of the body)
    • The ABG is often regularly done in critically ill Patients who require Hemodialysis or Renal replacement therapy for kidney failure
    • The ABG is also done 2-3 hourly if your loved one has just come back from surgery or has invasive therapy such as ECMO

    The Arterial blood gas(ABG) is easily and quickly performed and the results are available within less than 5 minutes and the Intensive Care team has a tendency to check the ABG many times a day. In critical and emergency situations those tests may be done every two hours or even more frequently. However if your critically ill loved one is stable, those ABG’s should only be necessary 3-5 times a day.

    The Intensive Care team has a tendency to check bloods all the time

    What you need to be aware of is that Intensive Care Unit’s definitely have a tendency to take more blood tests than necessary, as more often than not, the doctors and the nurses are virtually only a doorstep away from an Arterial Blood Gas(ABG) analyser in Intensive Care and also Doctors tend to order many Pathology(blood) tests and if they are in doubt whether a Blood test is really necessary, they will order one anyway.

    So therefore, if you have any concerns you shouldn’t hesitate in asking those questions. In general you should always ask questions anyway and you should always make up your own mind about the situation your critically ill loved one is in whilst in Intensive Care, irrespective of whether you’re a doctor or a nurse.

    You can do so by reading our blog and our “your questions answered” section. Here are a few related articles that will help you and your Family to maintain control, power and influence of your critically ill loved one’s destiny! Click on the articles so you can read them!

    What you need to do if your loved one is critically ill in Intensive Care 

    How to make sure that what you see is always what you get, whilst your loved one is critically ill in Intensive Care

    The 3 most dangerous mistakes that you are making but you are unaware of whilst your loved one is critically ill in Intensive Care

    How long is a Patient kept on a BIPAP machine in Intensive Care?

    How long can a breathing or endotracheal tube stay in?

    As a rule of thumb, you should never give your critically ill loved one’s destiny outside of your hands and you should make sure that you have the most power, control and influence there is. How do you do that?

    How can you leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?

    You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!
    In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now! In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!
    In your FREE reports you’ll also discover

    • how to ask the doctors and the nurses the right questions

    • how to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying

    • 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation

    • you’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care

    • how you need to manage doctors and nurses in Intensive Care(it’s not what you think)

    With your FREE “INSTANT IMPACT” report you’ll also get 4 other FREE reports and the reports you will be receiving are

    • The 6 questions you need to ask the most senior doctor in Intensive Care
    • 10 things you didn’t know doctors and nurses are talking about while you are not at the bedside with your loved one
    • The 7 answers to the 7 most FAQ if your loved one is critically ill in Intensive Care
    • 9 myths of being a critically ill Patient in Intensive Care

    Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to support@intensivecarehotline.com with your questions!
    This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

    Sincerely,
    your Friend
    Patrik Hutzel

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