Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So today I’ve got a question from John and John asks, is it possible to have a tracheostomy while the patient is in an induced coma and sedated? What a great question, John. Let’s dive right into it.
So when somebody is in an induced coma and sedated, they also have a breathing tube or an endotracheal tube to begin with. Basically the breathing tube is in the back of the throat, stuck at the tip of the lungs attached to a ventilator. In order to facilitate a breathing tube or an endotracheal tube and mechanical ventilation, patients always need to be in an induced coma and on sedation because it’s so uncomfortable going through that process of mechanical ventilation and with the breathing tube. The time frames of mechanical ventilation with a breathing tube are about 14 days and if you’re still in an induced coma after about 14 days and you can’t come off the breathing tube or you can’t be woken up for whatever reason, the next step is to do a tracheostomy.
Once a tracheostomy is done, then it’s much easier to take away sedation and take a patient out of the induced coma because again, the discomfort of the breathing tube or the endotracheal tube being stuck in the back of your throat and being stuck in the lungs has gone away. The tracheostomy sits in the neck, it’s more or less painless and once the tracheostomy has been done, most of the time sedation can be weaned off. Patient can be taken out of the induced coma because there is no longer a need for the induced coma.
Most of the time, there are exceptions to the rule. There are some exceptions where a patient with a tracheostomy needs to be in an induced coma as well, but most of the time the tracheostomy is done to move away from the sedation and the induced coma.
So that’s my tip for today. Go and check out our case studies at intensivecarehotline.com where you find more questions answered. Like the video comment down below what you want to see next and like my YouTube channel. This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.