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 explained
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
“My 25 year old wife has been in ICU for one month with Tracheostomy and is still in an induced coma”
“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?
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” or a “limitation of treatment” is “in the best interest” for your loved one, whereas in reality, a “withdrawal of treatment” or a “limitation 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” or a “limitation of treatment” is “in the best interest” for your loved one, whereas in reality, a “withdrawal of treatment” or a “limitation of treatment” is in the best interest of the Intensive Care Unit
- THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO “LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT” OR “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR AN “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!
- FOLLOW THIS PROVEN 6 STEP PROCESS, ON HOW TO BE POWERFUL, IN CONTROL, INFLUENTIAL AND HAVE PEACE OF MIND, IF YOUR LOVED ONE IS A LONG-TERM PATIENT IN INTENSIVE CARE OR IS FACING TREATMENT LIMITATIONS IN INTENSIVE CARE!
- 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
- If the Intensive Care team is doing their best, then a prolonged stay in Intensive Care may well be necessary, find more information here about a long term stay in Intensive Care “My sister has been in ICU for 21 weeks with Tracheostomy and still ventilated. What do we need to do?”
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?
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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
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- 5 “killer” tips& strategies helping you to get on the right path to control, power and influence in your situation
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- 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!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
Sincerely, your Friend