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 make informed decisions, get 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 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
- Open heart surgery
- Sepsis(globalised severe infection often resulting in multi-organ failure)
- Severe head or brain injuries
- Heart attack
- Heart failure
- Cardiac arrest
- Abdominal Aneurysm repair
- ARDS or lung failure
- Drug overdose
- Guillan- Barre syndrome
- Liver failure
- Liver transplant
- Heart transplant
- Lung transplant
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):
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 PEACE OF MIND, 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 become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, 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
- 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 make informed decisions, get PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s 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 [email protected] with your questions!
Also check out our Products section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via phone or Skype or via email!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
Sincerely, your Friend