Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

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

So this week, I was talking to a client who said that their 78-year old father has gone into ICU with a pneumonia and is currently on high flow nasal prongs. And the ICU team is talking about that if he’s not improving, he needs to go on BiPAP (Bilevel Positive Airway Pressure) as a next step.

And the client is asking, “How do we avoid BiPAP in a situation like that?” So that’s a really great question and let’s break this down. So when someone is in ICU on high flow nasal prongs for a pneumonia, for example, the first thing that needs to happen is obviously find out the cause of the pneumonia, start them on antibiotics or antivirals or antifungals depending on the cause of the pneumonia.

Obviously, assess a chest x-ray, assess oxygen saturation, assess an arterial blood gas ideally, do a chest x-ray and also have a listen to the chest with the stethoscope. Doctors and nurses do that in ICU quite frequently. And then assess, whether how unwell the patient is, how unwell your dad is, and also look at signs such as the breathing rate per minute. Is it fast? Is it slow? Is it shallow? Can your dad take deep breaths? Can he cough? Because that is really important to keep someone off BiPAP to do deep breathing exercises, to do coughing exercises, to mobilize, to get out of bed so that when someone is lying in bed all day in ICU, their lungs can’t expand. Whereas if someone is sitting up, their lungs can expand and therefore, areas of the lungs that are not perfused well, that are not oxygenated well, that are potentially collapsed with the pneumonia can open up. So, mobilization, deep breathing exercises, coughing, physical therapy, ideally, antibiotics, antivirals, antifungals, whatever works that can be very effective.

Now, other things that can help is, for example, saline nebulizers, or depending on the medical history of a patient, also other nebulizers, such as Salbutamol or Atrovent nebulizers may help as well. So I hope that helps how to avoid BiPAP in ICU when someone is on high flow nasal prongs.

And that’s my quick tip for today.

Now, if you have a loved one in intensive care, go to intensivecarehotline.com and call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

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

If you need a medical record review, please contact us as well. We review medical records for our clients while they have a loved one in ICU in real time and also after ICU, especially if you suspect medical negligence. But it’s obviously more important that we can interpret clinical data for you while your loved one is in ICU, so we can set you up with the right questions or ask the questions on your behalf so that you have maximum input and maximum peace of mind when your loved one is in intensive care.

Now, if you like this video, give it a thumbs up. Subscribe to my YouTube channel for regular updates for families in Intensive Care and Intensive Care at Home. Click the notification bell, share the video with your friends and families, and let me know in the comment section what you want to see next, or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I’ll talk to you in a few days.