Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So yesterday I was talking to a client and the client’s 10-year old daughter is in ICU with Left Hypoplastic Heart Syndrome.
Now, initially the client’s daughter went on ECMO for heart failure, and then she got weaned off ECMO. She was doing quite well. All the time she’s been on a ventilator and the breathing tube and in an induced coma. After she came off ECMO, she had a cardiac arrest and then obviously survived the cardiac arrest with CPR.
Now here’s the client’s dilemma, so the client’s daughter is still in an induced coma after about four weeks in ICU, and she’s still on sedation and vasopressors and she has been asked to sign a DNR or “Do Not Resuscitate” order.
Now, given that my client’s daughter is still in an induced coma, the first thing that needs to happen in a situation like that, she needs to get out of the induced coma, needs to have a tracheostomy because with the tracheostomy, the client’s daughter can be removed from the induced coma, can be woken up and also the need for vasopressors, which is a form of life support is reduced.
And also, the ICU team should not ask for a DNR to be signed because we’re talking about a 10-year old girl here that has a life to live. And the survival rate for left hypoplastic heart syndrome is actually up to 90%. So there is no reason for the ICU team not to give it their best shot, which is what’s happening in this situation, they’re not giving it their best shot.
My client’s daughterI should have a tracheostomy, get out of the induced coma, have the vasopressors removed and then potentially go home with a service like intensive care at home if she can’t be weaned off the tracheostomy or the ventilator.
If you are in a similar situation, you should certainly never agree to a DNR because the minute you are agreeing to a DNR or do not resuscitate, you are basically asking the ICU team not to give your family member their best care and treatment. That’s basically what you’re implying the minute you are signing a DNR.
Again, the biggest challenge for families in intensive care is simply that they don’t know what they don’t know. So for example, my client didn’t even know yesterday that a tracheostomy was an option. The ICU team has never suggested it to my client. So, you know, you don’t know what you don’t know.
And as you can see in this situation, ICU’s are not always transparent. They’re not always telling you what options are available to you, unless you can ask the right questions. And that’s where we can help at intensivecarehotline.com.
We are professional advocates and consultants for families in intensive care with hundreds of years of ICU experience that we are bringing to the table here with our team of ICU nurses.
So that is my tip for today.
If you have a loved one in intensive care and you need insights, consulting and advocacy, because you won’t get that from the intensive care team, unless you have the right questions to ask, contact us at intensivecarehotline.com on one of the numbers on the top of the website.
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This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days, take care.