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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 some questions that I had from a client and the client has their 94-year old mother in ICU after heart attacks, query stroke, also after CPR was performed after cardiac arrest and the client’s mother had potentially a hypoxic brain injury after the cardiac arrest and she’s now in intensive care for about 12 days, and she’s not waking up.  So here are some questions from the client that I want to answer, and that will help you as well to make informed decisions, have peace of mind, control, power, and influence when your loved one is critically ill in intensive care.

So the client asks,

Can a tracheostomy be avoided for 30 days?

Patrik: Yes, but not with undesired side effects, such as pain, discomfort, vocal cord damage, and the risk of the breathing tube or endotracheal tube be removed accidentally and leading to a respiratory arrest, cardiac arrest, and therefore death.

In giving time for the hypoxic injured brain to heal, it can take 17 to 37 days to wake up from being comatose in some cases, can we wait it out safely and not do a tracheostomy?

Patrik: Waking up from a hypoxic brain injury can take weeks, months, sometimes even years, how long is a piece of string.

At which time is it absolutely mandatory to do a tracheostomy?

Patrik: In order to avoid further damage and sedation, a tracheostomy is mandatory after 10 to 14 days of ventilation with a breathing tube or endotracheal tube.

When can it be too late to do a tracheostomy?

Patrik: And again, I’m referring back to my other answers before, because that pretty much answers that you need to do a tracheostomy as quickly as possible within 12 to 14 days if the breathing tube cannot be removed.

What percent of patients with brain injury actually get a tracheostomy removed and how soon after putting it in, will it be removed realistically, in this case, in an ideal world?

Patrik: Very few with a permanent hypoxic brain injury.

If this was your mother, would you absolutely do a tracheostomy right now?

Patrik: And my answer to this is yes.

When you have a loved one in intensive care for about 10 to 14 days with a breathing tube, having a hypoxic brain injury, not waking up, should you do a tracheostomy? Yes or no?

Patrik: And my answer is absolutely, yes.

We have other articles and videos on our website that talk more about when to do a tracheostomy. You should check them out, type into our search box:

How long should a breathing tube stay in before a tracheostomy is done? And also another article,

Why does a tracheostomy need to be done when someone is in a prolonged induced coma? 

So that is my quick tip for today.

If you have a loved one in intensive care, I know you need help, check out intensivecarehotline.com. Call us on one of the numbers on the top of the website or below this video. Like this video, comment down below what questions that you have, subscribe to my YouTube channel for updates for families in intensive care.

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