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

So, yesterday I had an email from a reader and Patricia asked, my father has been in intensive care now for 12 days and he’s in an induced coma and ventilated with a breathing tube for the last 12 days.

He initially went into ICU with a heart attack and now developed pneumonia and he’s not waking up and can’t be taken off the ventilator. Should he have a tracheostomy?

Now I know from Patricia that her father is still in an induced coma because the pneumonia still has not cleared up and his x-rays still consolidated and he’s still on a fair bit of support from the ventilator.

So basically she’s asking, should we have a tracheostomy after Day 12 or not? Let’s look at this in more detail.

So generally speaking, a tracheostomy should be done after day 10 to day 14 of mechanical ventilation with the breathing tube or an endotracheal tube. The breathing tube or the endotracheal tube is usually kept in the mouth and in the back of the throat.

So, this is very uncomfortable and it’s often one of the reasons why a critically ill patient needs to go into an induced coma so they can actually tolerate the breathing tube and the endotracheal tube.

If after day 12, your father still can’t wake up and he still can’t be taken off the ventilator, then a tracheostomy is a consideration.

However, it really depends on how far away your father is from waking up after the induced coma. How far away is he from weaning off the ventilator? How far away is he from regaining consciousness so he can obey commands, he can maintain the safe airway once he’s off the ventilator. So those are all the questions that need to be asked.

So it’s not as simple as, does he need a tracheostomy, yes or no? The answer to that question is, it depends.

So one thing that always happens in intensive care is that the biggest challenge for families in intensive care is simply that you don’t know. So what do I mean by that?

When looking at a situation like this, whether your loved one needs a tracheostomy after day 12, again, it really depends.

It depends on the medications he’s on. It depends on the chest x-ray results. It depends on the arterial blood gas results. It depends on the ventilator settings. It depends on medications that he is on. It depends on what other mechanisms of life support he is on.

So you can already see that because intensive care is such a highly specialized area, the question like this needs to be looked at from multiple angles.

And the doctors often don’t have the time or they are not interested in explaining those things in detail to you because they think you would not understand anyway. Well, I think nothing is further from the truth. You just need to be educated on it and you just need to understand what’s happening in detail.

You basically need a crash course in intensive care and that’s what we are offering here at intensivecarehotline.com. We help you understand what’s happening in intensive care in detail so that you can make informed decisions, have peace of mind, control, power and influence fast because that’s what you want at the end of the day.

So, it is critically important that you know what to look for, know what questions to ask. And also that you know how to manage doctors and nurses in intensive care. 99% percent of families in intensive care, they don’t even think it’s an option to manage doctors and nurses and the intensive care team.

But here at intensivecarehotline.com, me and my team, we could show you and we can hand-hold you how to manage doctors and nurses in intensive care so that you get better outcomes.

So we have multiple case studies on our website at intensivecarehotline.com where you can actually read about when to do a tracheostomy, what to look for.

But the shortcut obviously is, if you are in a similar situation and you and I could get on the phone and then we can get on the phone to the doctors and to the nurses so that you have the strong clinical advocate by your side, who can actually challenge the doctors on a clinical level so that you, again, get the best outcomes for your loved one and for your family.

If you don’t ask the right questions, and if you don’t know what to look for, if you don’t know how to manage doctors and nurses, you’ll be fighting an uphill battle and you will probably never get the outcomes that you would like because the doctors and the nurses will keep the upper hand unless you have a clinical advocate by your side that can advocate for you on a clinical level and can challenge the doctors and the nurses on a clinical level.

That is my quick tip for today.

Like this video, comment down below what you want to see next. Subscribe to my YouTube channel. If you have a loved one in intensive care, call me on one of the numbers on the top of the intensive care hotline website and I’ll talk to you soon.

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