Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So, we have a client at the moment asking us whether their loved one should have a tracheostomy after a couple of weeks of ventilation, still in an induced coma, and still doesn’t wake up, still can’t come off the ventilator.
So they are asking whether their loved one needs a general anesthetic to have a tracheostomy, because that’s what the ICU team is suggesting. They are suggesting a tracheostomy, but they are also suggesting that she needs to go to have surgery in theater and that she needs to have a general anesthetic. And they’re saying she’s too weak, too unstable for a general anesthetic.
Now that might be the case, but generally speaking, the tip today really is that, a tracheostomy, a percutaneous tracheostomy can be done in ICU. It’s a fairly quick procedure and experienced intensive care consultant can do it within half an hour, three-quarters of an hour if it’s uncomplicated.
Does need some sedation, does need some muscle relaxants, some paralytics, but generally speaking, a quick procedure that can be done even when patients are unstable in ICU, on inotropes or vasopressors. So no surgery needed most of the time. It can be done in ICU, much quicker, much smoother. And then the job is done.
That’s my quick tip for today.
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This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.