Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So currently we’re working with a client who has their 78-year old father in ICU with lung cancer and a sepsis. Now, thankfully, his father is not ventilated at the moment, but he needs some oxygen and his arterial blood gases are quite stable, but obviously with being a lung cancer patient, the risk is there that an intubation might be next and also he has a pneumonia plus the sepsis.
So it’s a tricky situation and in a situation like that, you’ve got to make sure that your loved one can breathe independently, sitting up, ideally gets out of bed, which is not often possible, especially with the sepsis when patients are on either inotropes or vasopressors. But nevertheless sitting up is the least you can do to keep your loved one off the ventilator because somebody with lung cancer needing to be intubated and going on a ventilator, it’s going to be very difficult to wean them off the ventilator.
Now, my client has told me that his father is on a sedative called Precedex also known as Dexmedetomidine. Now, a sedative, it’s really contraindicated for anybody that needs to stay off the ventilator. And it’s critical that my client starts challenging the intensive care team to take away the sedative.
Now what’s happening on top of everything that I explained so far is that the intensive care team is pushing my client to sign a DNR, a “Do Not Resuscitate” order for his dad and also move him to hospice, which would basically mean end of life care and they want to let him die. Now, therefore, I’m not too surprised that they started him on Precedex to potentially let him deteriorate and let him inhibit his respiratory drive and then he might end up on a ventilator or they might then go back to my client and say, “Hey, look, your father is deteriorating. Let’s just move him to hospice, sign a DNR, let’s withdraw treatment” and so forth.
It all comes back to what I say over and over again, the biggest challenge for families in intensive care is that they don’t know what they don’t know. And if you don’t know what certain drugs mean in intensive care, if you don’t know treatment options, if you don’t know your rights as a family in intensive care, you’re pretty much fighting a losing battle.
So that’s my tip for today. Watch out for sedatives if your loved one is off a ventilator because that’s just a recipe for disaster and any sedatives on when your loved one is off a ventilator in intensive care could lead to ventilation and that needs to be avoided at all costs.
Now, if you have a loved one in intensive care and you need help, check out intensivecarehotline.com, where we have hundreds of case studies of families in intensive care, how we help them. Send me an email to [email protected] or call me on one of the numbers on the top of our website. Like the video, comment down below what questions you have and like my YouTube channel.
This is Patrik Hutzel from intensivecarehotline.com. And I’ll talk to you in a few days.