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, currently we are working with a client who has their 71-year-old father in intensive care with a GI (gastrointestinal) bleed or a suspected GI bleed, I should say. So, here’s what’s happened.

Our client’s father is in ICU, has been there for about four weeks now, ventilated with a breathing tube still, and he’s got multiple complications. And then all of a sudden, the client’s hemoglobin dropped down to 6, which suggests there is a suspected bleed somewhere. And whilst the intensive care team was putting it down to a GI bleed, there’s really no evidence for it. The CT (Computerized Tomography) scan could not be showing anything in regards to that, couldn’t locate a bleed in the abdominal region. There was no vomiting of fresh blood. There was no coffee ground coming up from the nasogastric tube.

There was residual i.e. feeds that could not be digested from the nasogastric tube, but there was no fresh blood. There was some blood in the stool, but that was done through a test. Wasn’t really sort of visible. There was no melena, which is another sign if there’s dark stool coming out. That’s also another sign of a GI bleed. So really no real signs that there is a GI bleed, even though they were treating it as such. They were starting a pantoprazole infusion. They were giving blood transfusions. Platelets became very low. They dropped down to a really low level and they were replaced as well.

So how can a GI bleed be diagnosed and what’s the treatment? So, I already hinted on the treatment in terms of giving a pantoprazole infusion or increasing PPI (proton pump inhibitors) because often the cause of a GI bleed is simply an acid environment in the stomach and in the upper GI where the pH is going off and that’s causing ulcers that could then lead to GI bleeds. So, treatment again is proton pump inhibitors like pantoprazole, but also a gastroscopy, which they haven’t done yet. And then stop the bleeding by clipping an artery or a vein, wherever the bleeding might be coming from. Those are the other treatment options as well. So, it really comes down to people asking the right questions. It comes down to getting that second opinion that we can help you with here at intensivecarehotline.com. And it really comes down to the client had no idea where to start. What questions to ask? Is it really a GI bleed? What are the signs of a GI bleed? We haven’t really seen any signs besides the massive hemoglobin drop. There’s no other suggestion that the client might be bleeding from somewhere else.

Again, from my experience after having worked in intensive care for over 20 years in three different countries, gastroscopy should be the next step. That’s from my experience. Hopefully that is what’s going to happen.

So that is 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 or simply send us an email to [email protected].

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

If you need a medical record review for your loved one in intensive care, while your loved one is in intensive care, we can help you with that. We can also help you with the medical record review after intensive care, but we strongly recommend doing a medical record review while your loved one is intensive care, so we can interpret live data, so you can get the opinion from us and the interpretation from us, what’s really happening, whilst your loved one is in intensive care. But we can also ask questions to intensive care teams directly of course.

Like the video, subscribe to my YouTube channel, share the video with your friends and families. Click the notification bell and comment below what you want to see next and what questions and insights you have.

Thanks for watching.

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