Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

If you want to know what it means if your loved one can’t protect the airway when it comes to extubation or the removal of a breathing tube, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today I have an email from one of our clients Mel who says,

“Hi Patrik,

Thank you so much for talking to the nurse and the ICU doctor. After the call, I stepped in to see my grandmother. She was opening her eyes, and she even moved her legs a bit. They went in to suction her and I could tell that it causes a lot of discomfort for her because she opens her eyes, she opens her mouth and she’s trying to move a little bit. The respiratory person who did the suctioning said that’s the most awake he has seen her and that he had run a spontaneous breathing trial, and she actually did really good on the spontaneous breathing trial. It’s just that she can’t protect her own airway. What does she mean by that?”

That’s a great question to ask, Mel.

Here’s what that means, let’s just quickly go one step back.

So, when someone is on a breathing tube and you’re working them up for extubation i.e. the removal of the breathing tube to avoid the tracheostomy, I’ve done a video on it and the blog post about how to remove the breathing tube for a critically ill patient in intensive care and the steps towards that. I will link towards it below this video in the written version of this blog.

So, what that means is, a patient needs to be awake. They need to breathe spontaneously for a period of time. The arterial blood gases need to be good. They need to obey commands. The chest X-rays need to be good, minimal suctioning, and they need to be able to protect their own airway. What does that mean? It’s quite simple. Two things predominantly, (1) they need to be able to have a good cough reflex because imagine you’re taking out the breathing tube and they can’t cough out their own saliva, their sputum, it would go down in the lungs, and then it would cause an aspiration pneumonia.

That exactly leads me to the next thing, (2) they also need to be able to swallow. If they can’t swallow, they have difficulty swallowing, once again, they’re at high risk of aspiration, of aspirating saliva or, God forbid, if they vomit, they can’t protect their own airway, and then saliva or stomach content would go into the lungs causing aspiration pneumonia. That’s what it means if they can’t protect their own airway. It is actually a contraindication to extubation in a situation like that. A tracheostomy often needs to happen to protect the airway. It doesn’t mean that tracheostomy and ventilation need to happen, but a tracheostomy often needs to happen to protect the airway because a tracheostomy can inflate the balloon and then that protects from aspiration.

If someone can’t cough, you also need the tracheostomy because that means you can suction secretions through the tracheostomy, again, clearing out secretions that otherwise wouldn’t be cleared out. That would lead to chest infections and pneumonia.

So, I hope that helps you understand what it means that someone can’t protect their own airway when they are being worked up for extubation or removal of the breathing tube in intensive care.

I’ve worked in critical care and nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say we have saved many lives as part of our consulting and advocacy here with intensivecarehotline.com. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we’ve done client interviews verifying the work that we’ve done for them and with them.

We have helped hundreds of members and clients over the years helping them to improve their lives instantly, saving their lives. That is why we created a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded, and you will have access to that as well. All of those resources will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always.

I do one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. I also talk to doctors and nurses directly. When I talk to doctors and nurses directly on your behalf or with you on a three-way call, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

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

Take care for now.