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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today’s tip is about, again, a frustration that one of our readers shared, and the reader says, “My 74-year-old mom has been in ICU for three weeks now. She’s had a tracheostomy seven days ago, but she’s not waking up even though all sedation has been off for a week since she had the tracheostomy. What should I expect?” Well, here is what you can expect.

First off, it would’ve been good to know why your mom is in ICU, you haven’t shared any of that. Your mom might be in ICU for a pneumonia, for some form of surgery, for a neurological condition such as a hypoxic brain injury, traumatic brain injury, seizures, stroke. You haven’t shared any of that because clearly there would need to be a distinction made between whether your mom is in for any condition or for a neurological condition.

For example, if she’s in it with a brain injury , seizure, stroke, whatever the case may be, then, you almost, you can’t expect that. And I come to a solution in a minute, but if your mom is in ICU for a pneumonia, for trauma, for, maybe she’s post-surgery, maybe she had open heart surgery, whatever the case may be, then you should definitely have your mom expect to wake up. And if she’s not waking up, if she’s got no brain injury, then the next step is to do a CT of the brain or an MRI (Magnetic resonance imaging) scan of the brain. Get some neurology input to rule out a stroke, or to rule out any neurological damage. That would be really important. But on top of that, what also needs to happen, let’s assume there’s nothing stopping your mom from getting mobilized. She should be getting mobilized because that will stimulate her brain.

Imagine you’re lying in bed for weeks on ends. That’s not going to help you wake up, is it? So, all ICUs should have like mobilization chairs, recliner chairs, tilt tables, whatever the case may be so the excuse your mom can’t get mobilized is not really an excuse to use because that can be done. Again, assuming your mom doesn’t have any contraindications such as fractures, she’s hemodynamically stable, and there’s nothing stopping her from getting mobilized and not being awake should not stop her from getting mobilized. Full stop.

Now, if your mom has a neurological condition. Again, you need some input from the neurologist, but once again, and you might expect that to take longer to wake up, but nevertheless, she should be mobilized. Now, she should get mobilized one way or another.

Now, how long does it take? It’s hard to say, but if there’s no brain damage, then you just keep plodding along. The question here is, if you have children, if you expect children to walk after 12 months, if they don’t walk well, the question is, how long would you give your child to walk? Well, would you stop at 18 months? No, you wouldn’t.

So the question really is, how long do you give your mom to wake up? Well, don’t give up. Keep stimulating her, keep talking to her. ICU should be mobilizing her. As I said, it’s no real timeframe, but you wanted to wake up in the meantime, she needs physical therapy, and so forth. So don’t give up. So that is my quick tip for today.

And if she doesn’t wake up, God forbid, and she can’t come off the ventilator with the tracheostomy, you can look at options such as Intensive Care at Home, have a look at intensivecareathome.com. We operate all around Australia and all major capital cities, including regional and remote areas.

And if you’re in the United States and you’re looking for intensivecareathome.com, you should contact us as well. We can help you in the United States too.

That’s my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website.

Also have a look at our membership for families in intensive care at intensivecaresupport.org. There you have access to me and my team 24 hours a day in a membership area and via email, and we answer all questions intensive care related.

And if you need a medical record review for your loved one in intensive care or after intensive care, we can help you with that as well. We strongly recommend that you get access to medical records from day one when you have a loved one in intensive care, and we can help you with interpreting clinical data from day one so that you can actually make informed decisions, have peace of mind, have control, power, and influence because otherwise, intensive care teams will only tell you half of the story. And as I keep saying over and over again, because the biggest challenge for families in intensive care, is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask, they don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

 

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Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and intensivecareathome.com and I will talk to you in a few days.