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If you want to know if your loved one should go to LTAC when they’re in an induced coma and on 100% of oxygen in intensive care, stay tuned! I’ve got news for you.

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

So, currently, we are working with a client who has their 63-year-old husband in ICU after cardiac arrest and hypoxic brain injury. They were initially told that the best way course of action here is to withdraw treatment of life support because if the husband will survive the intensive care stay, they won’t have any “quality of life”. That was the perception of the intensive care team.

We advised the family early on that if they were to withdraw treatment, you know the outcome, the patient is going to die. If you don’t withdraw treatment, you don’t know the outcome, and there may be some suffering and there may be quality of life issues, but at least you’re giving people a chance to get through this. The family decided to go on with treatment.

Interestingly enough, then the ICU team was changing their narrative talking about, “Well, now then we should do a tracheostomy and send out the patient to LTAC (Long Term Acute Care) as quickly as possible.” Instead of trying to wean the patient off the ventilator, there was still time, it was only around Day 7. When they were doing the tracheostomy at that stage, we were not involved yet, otherwise, we would have said, “Well, Day 7 is too early. Let’s keep trying to wean the patient off the ventilator and let’s revisit the tracheostomy after Day 10, Day 14, in case there’s progress to be made with weaning off the ventilator.”

Cutting a long story short, that didn’t happen. The patient ended up with a tracheostomy. Then, as soon as the patient had the tracheostomy, they didn’t do a PEG (Percutaneous Endoscopic Gastrostomy) tube, still got a nasogastric tube. Don’t give consent to PEG tubes as a rule of thumb, especially if you’re in the U.S. and you’re potentially facing a discharge to LTAC. Never give consent to a PEG tube, I’ve done plenty of videos around that topic.

Then, when the family reached out and said, “Hey, they want to send us to LTAC.” I said, “Hey, number one, if he doesn’t have a PEG tube, it’s unlikely.” Most LTACs cannot take nasogastric tubes and that should tell you everything about the skill level that an LTAC has. It’s very low. If they can’t look after a nasogastric tube, how can they possibly look after a ventilator and a tracheostomy?

Once again, the biggest challenge for families in intensive care is simply 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. 

So, family was being pushed towards LTAC. But then, it turns out the patient is on 100% of oxygen, so the air that you and I are breathing which is room air is 21% of oxygen, and now he’s got 100% of oxygen. He’s on dialysis, he’s on inotropes and vasopressors such as norepinephrine, vasopressin. He’s on a heparin infusion or amiodarone infusion. He’s got many things working against him and the ICU wants to send him to LTAC.

Now, let me be clear. LTAC is not even the better version of a nursing home. Can you now see why you need a second opinion when you have a loved one critically ill in intensive care? You absolutely need a second opinion to handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. 

He would bounce back to ICU in no time. He’s got so many things going on including atrial fibrillation because he’s on amiodarone. He’s also got a low hemoglobin level, making him more likely to needing blood transfusions. On 100% of oxygen, there’s no way that an LTAC would be able to take him. His blood gases are extremely low.

So, 99.9% of families in intensive care simply don’t question. They have no idea what they’re dealing with. If it wasn’t for our input here, the family might have signed off on him going to LTAC and this patient would die in LTAC, or he would bounce back into another ICU. There’s no way that LTACs can manage 100% of oxygen. No way LTACs can manage inotropes or vasopressors. No way LTACs can manage the dialysis. They might be able to manage one aspect of it at the most, but certainly not all of it combined.

There are plenty of case studies on our website at intensivecarehotline.com where patients have bounced back from LTAC to ICU in less than 24 to 48 hours. You have to question the clinical judgment of the intensive care team if they’re even suggesting discharge to LTAC. in a situation like that.

So, always get a second opinion. Always read between the lines. Always look at the facts. We can break down the facts for you here at intensivecarehotline.com. We have helped hundreds of members and clients over the years.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years. We have been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can confidently say we have saved many lives for our clients and members and that is verified and documented on our testimonial section at intensivecarehotline.com. It’s verified and documented on our intensivecarehotline.com podcast section at intensivecarehotline.com because there we’ve got some client interviews.

That’s why we created a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you call us on one of the numbers on the top of our website, or if you simply send us an email to [email protected] with your questions. But you can also get access to the membership if you go to intensivecarehotline.com by clicking on the membership link, or by going 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 get access to that once you are a member. It 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 also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, 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, 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 video, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, and share the video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on a 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.

Related Articles:

Quick Tip for Families in ICU: Weaning VA-ECMO for Heart Failure, Do you Need Milrinone or Dobutamine? Quick Tip for Families in ICU: Can a Tracheostomy be Done While your Loved One is on ECMO? Quick Tip for Families in ICU: What Questions to Ask When Your Loved One is in Heart Failure in ICU! Quick Tip for Families in ICU: What are Signs that My Mom can be Weaned Off the Ventilator in ICU? Quick Tip for Families in Intensive Care: Why is My Mom Not Waking Up After Two Weeks in an Induced Coma and Paralyzing Agents After Acute Respiratory Distress Syndrome (ARDS)?