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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So in today’s tip, I want to talk about another success story. So we are currently working with a client who has their 91-year old mother in ICU. Initially, she had a hemicolectomy, she had some bowel resections, after she had a bowel obstruction. And then she ended up with pneumonia in intensive care. She has now been ventilated for about two weeks. Now, bear in mind, this lady is 91 years of age, but previously has been fit and healthy.
So, last week we had a family meeting with the palliative care team and with the intensive care team. And the lady was still in an induced coma, was ventilated with a breathing tube and the intensive care team was pushing towards end-of-life and said that she will never wake up and that she will not even survive for 48 hours of their stay in intensive care.
So we objected to that because the biggest challenge for families in intensive care simply is that they don’t know what they don’t know . So what do I mean by that?
Families in intensive care don’t know that 90% of intensive care patients approximately survive. So one of the first questions you as a family in intensive care need to ask, you need to ask, why would your loved one not survive if the odds are in their favor? And we then question, rather than doing a “one-way extubation” while still on sedation and basically letting their loved one die because they’re still on sedation. And then they wouldn’t wake up and possibly suffocate. We were opting for a tracheostomy for that particular lady. And the intensive care team reluctantly agreed to that.
And not even one week later, she’s now slowly waking up and she still hasn’t got the tracheostomy, but the reality is, this lady is waking up and she’s doing purposeful movements. She even went as far as removing her breathing tube on purpose. Now she’s not ready to be extubated yet, but those are good signs. So the bottom line here is this, you got to question everything in intensive care.
As I said, 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 that’s where we can help you with here at intensivecarehotline.com.
Here’s the moral of the story. As I said, you’ve got to question everything. You’ve got to question the motives of the intensive care team. Now intensive care resources are in short supply, whether it’s staff, whether it’s equipment, whether it’s beds, especially with COVID still running rampant.
So, by extubating someone and providing end-of-life care, which is a euphemism for letting someone die, they’re freeing up a bed. Their biggest problem is solved. Now by having someone, having a tracheostomy and potentially a PEG tube (Percutaneous Endoscopic Gastrostomy), they could stay in intensive care for long periods of time. And that is the intensive care team’s worst case scenario.
Their worst case scenario is looking after someone indefinitely with an uncertain outcome, and this lady potentially fits the criteria. But again, on the positive note, she had now some spontaneous breathing trials where she was breathing on CPAP or some pressure support for a few hours. That’s a great start. So, going from, she’s not even going to survive 48 hours now, one week later, having breathing trials, waking up, making eye contact, obeying commands, such as squeezing fingers, poking out tongues, wiggling toes. There’s a big difference there.
And now, this lady can actually make up her own mind on what she wants. Does she want to die? Does she want to tracheostomy? Does she want to do more breathing trials? Now this lady is in a position where she can make up her own mind. She doesn’t need other people to make decisions for her. And the intensive care team’s job is to provide best care and treatment and making sure this lady is in a position to make up her own mind despite her age. It’s not a matter of age. It’s a matter of personal choice.
That is my quick tip for today.
Now, if you have a loved one in intensive care, go and check out intensivecarehotline.com, call us on one of the numbers on the top of our website, or simply send us an email to [email protected].
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This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.