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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip and questions answered for families in intensive care.

So I’ve got an email from a reader who says, “My sister had an emergency brain tumor operation. She was sedated and on a ventilator for a week. Now, the ventilation is off and she’s breathing by herself, but she doesn’t open her eyes yet so that the doctors can remove the windpipe from her throat.”

I think this lady is a little bit confused because she’s saying, now the ventilator is off and breathing by herself, but she doesn’t open her eyes yet so that the doctors can remove the windpipe from the throat.

So basically what that means is that she is on lower ventilator settings, probably something like CPAP or a BiPAP, and she’s breathing somewhat spontaneously, but she still needs a breathing tube in her mouth because she can’t protect her airway because she’s not awake yet.

Now, what that means is number one, you need to ask whether they’re doing everything beyond the shadow of a doubt to get your sister off the ventilator. You can do so, by checking out an article and the video that I made a while ago, where it says, “How to wean a critically ill patient off a breathing tube or an endotracheal tube.” And I will put a link below this video so you can watch the next video or read the article. That’s number one.

Let’s just say they are doing everything beyond the shadow of a doubt to get your sister off the ventilator, which means taking off sedation, mobilizing her, doing physical therapy, and doing everything that’s needed to get your sister off the ventilator. Let’s just say that’s going to fail. Let’s just say they have done everything to get your sister off the ventilator and the breathing tube beyond the shadow of a doubt. Then the timeframe is around 10 to 14 days to perform a tracheostomy as a next step.

Again, I’ve written articles and made videos about it. “How long can a critically ill patient stay on a ventilator and a breathing tube?” You can find the link again below this video. So if all that fails, the next step is to do a tracheostomy and then wean your sister off in her own time because a tracheostomy often buys time and is the right thing to do if someone isn’t waking up.

So those are the next steps I can totally understand and relate to your anxiety and know that you don’t know what’s happening. You’re also saying that your sister has been in ICU now for about seven days, which is not a long time. Seven days in ICU is not a long time. So you will need to be patient here.

And I can see from your email, once again, the biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care.

And I think that’s exactly what you’re challenged with here in any case, given that your sister must be breathing somewhat spontaneously. If she is waking up, they should be able to remove the breathing tube, assuming she can follow commands, she can open eyes. She can do what she was doing before she went into surgery. So that should be the goal and hopefully she can move towards that.

I would also talk to the neurologist if I was you and getting an opinion from the neurologist trying to find out, is your sister likely to wake up? Other things you need to consider, especially around brain tumors.

Has she had seizures? Is she still sedated? You mentioned sedation’s off, what has she been sedated with? Long-term acting sedation, short-term acting sedation. Is she or has she been on opiates? Because opiates, for example, one of the main side effects is respiratory depression. That might be one of the reasons why she’s still asleep and can’t breathe by herself yet. Very important questions to ask, so don’t give up yet.

Also if she has seizures, for example, which can happen after brain tumors or with brain tumors, is she having anti-seizure medications because they can also keep her sometimes lightly sedated? So I hope that’s giving you some good ideas, what to look for and what to ask, and not to give up. Again, it’s early days.

Now, if you’re finding these videos valuable, subscribe to my YouTube channel for regular updates for families in intensive care now.

And if you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org.

There, you have access to me and my team 24 hours a day in a membership area and via email and we answer all questions, intensive care related.

I also offer one-on-one consulting and advocacy for families in intensive care. I talk to doctors and nurses directly. I represent you in family meetings. I ask all the difficult questions and I ask all the questions you haven’t even considered asking because intensive care is such a highly specialized environment. And I provide one on one consulting over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you.

We also review medical records in real time if you need a second opinion in real time. So please contact us for that as well. We also provide medical record reviews after intensive care if you have unanswered questions, if you need closure or if you are simply suspecting medical negligence.

Now, thank you so much for watching.

Once again, if you find my videos valuable, subscribe to my YouTube channel, 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 or what questions and insights you have from this video.

Thanks for watching.

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

Take care for now.