My name is Patrik Hutzel from intensivecarehotline.com, and this is another quick tip for families in intensive care. At intensivecarehotline.com, we improve the lives for families of critically ill patients in intensive care instantly so that you can make informed decisions, have peace of mind, control, power and influence, making sure your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

I recently received this heartbreaking message from Jon:

Jon’s Question

“Hi Patrik,  Our dad was brought to the emergency room last Monday after having cardiac arrest at his home. I started CPR (cardiopulmonary resuscitation) immediately until paramedics arrived. They stabilized him and chose to drop his temperature to 33°C for 48 hours. They slowly warmed him back to a normal temperature and slowly withdrew pain and sedation medications.  His kidney was not working until they stopped those medications and had also cut back on blood pressure medication in hopes it would help him to wake up. It’s been a total of 6 days in the ICU, and we are wondering how long it could take for an 83-year-old with these conditions to wake from this?  Blessings,  Jon”

Jon, first of all, what you did — starting CPR immediately — may have saved your father’s life. That took real courage and quick thinking. Now your job is to become his advocate inside that ICU. I’m going to help you understand exactly what is happening, what to expect, and what questions to ask the ICU team.

What Is Targeted Temperature Management (TTM) — And Why Did They Cool Your Dad?

When the heart stops and is restarted, the brain is temporarily deprived of oxygen. This can cause significant neurological injury. To limit that damage, ICU teams use a treatment called Targeted Temperature Management (TTM) — also known as therapeutic hypothermia — where the patient’s body temperature is deliberately lowered, typically to around 32–36°C, for 24 to 48 hours.

In your father’s case, the team cooled him to 33°C for 48 hours. This is a well-established, guideline-supported treatment designed to reduce brain swelling, slow down cell death, and give the brain the best possible chance of recovery.

The important thing to understand is this: once the cooling phase is complete and the body is slowly rewarmed, the sedation and pain medications are withdrawn — but the patient does not always wake up immediately. This is completely expected and does not mean something has gone wrong.

How Long Does It Take for an 83-Year-Old to Wake Up After Cardiac Arrest and TTM?

This is the question every family asks — and it is one of the hardest questions to answer definitively, because recovery after cardiac arrest is highly individual. Here is what the evidence tells us:

• Sedation and pain medications(opiates) used during the cooling phase can take days — sometimes 3 to 7 days or longer — to fully clear from the system, especially in elderly patients whose liver and kidney function may be slower.
• Kidney impairment (as Jon mentioned) significantly slows drug clearance. Once kidney function begins to recover — which the team is trying to encourage by reducing blood pressure medications — the sedation drugs can finally be metabolized and excreted.
• At age 83, the body’s metabolism is slower. This means it is completely normal for it to take longer than it would for a younger patient.
• Neurological recovery after cardiac arrest can follow different timelines. Some patients begin showing signs of responsiveness within 24–72 hours of rewarming. Others may take 7–14 days or longer. In some cases, there is no meaningful recovery.
• The absence of waking up for 6 days does not necessarily mean there will be no recovery — but it also cannot be dismissed. This is a critical window for the ICU team to be conducting neurological assessments.

Key Insight

The fact that his kidneys were not working and blood pressure medications were still being adjusted tells me the team is still managing multiple organ systems simultaneously. Waking up is not just about the brain — all organ systems need to stabilize first.

Treatment Options and What the ICU Team Should Be Doing Right Now

Based on what Jon has shared, here are the key areas of treatment that should be underway or considered:

1. Neurological Assessment

The ICU team should be performing regular neurological assessments — including checking for purposeful movements, eye opening, response to voice and pain, and pupil reactions. They may also order:

• An EEG (electroencephalogram) to assess brain activity and rule out subclinical seizures
• CT scan or MRI of the brain to assess for hypoxic brain injury
• Somatosensory evoked potentials (SSEPs) — a specialist test that can help predict neurological recovery

2. Kidney Support

If the kidneys are not recovering adequately, the team may consider Continuous Renal Replacement Therapy (CRRT) — a form of slow dialysis used in ICU — to support kidney function and help clear toxins and residual medications from the blood.

3. Cardiovascular Stabilization

Reducing blood pressure medications is the right step if it is safe to do so, as this supports kidney blood flow. The team will be monitoring his heart rhythm, blood pressure, and cardiac output closely.

4. Respiratory Support

He is very likely on a ventilator. As neurological and kidney function improve, the team will begin trying to reduce ventilator support. If he is unable to breathe independently, a tracheostomy may eventually be considered — which I will address further below.

5. Nutrition and Prevention of Complications

ICU patients need nutritional support (via a feeding tube), prevention of pressure injuries, DVT (Deep Vein Thrombosis) prophylaxis, and mouth care. These are all parts of standard ICU care but worth asking about.

Goals of Care: The Conversation Nobody Wants to Have — But Must

Jon, I want to be honest with you, because that is what you deserve.

At age 83, after an out-of-hospital cardiac arrest, with initial kidney failure and prolonged unconsciousness, the statistical outcomes are sobering. That does not mean your father cannot survive and recover — many people do. But it does mean the family needs to have an open and honest conversation with the ICU team about goals of care.

This includes:

• What are the realistic best-case and worst-case outcomes the medical team is projecting?
• What does your father’s Advance Care Directive or Power of Attorney say, if one exists?
• What were your father’s previously expressed wishes about life-sustaining treatment?
• If he does not recover meaningful neurological function, what level of ongoing treatment is appropriate and what would he have wanted?
• Is the current treatment plan curative, or is it transitioning toward a comfort / palliative focus?

These are not conversations about giving up. They are conversations about honoring your father as a person — and making sure every decision is guided by his values, not just medical protocols.

This Is Why Advocacy Matters

Families who actively participate in goal-of-care conversations and who understand what is happening medically are far better equipped to make informed decisions and to ensure their loved one’s wishes are respected. You must be present, you must ask questions, and you must not feel intimidated by the ICU environment.

The Critical Importance of Accessing All Medical Records

Jon, one of the most important things you can do right now is request access to your father’s complete medical records. This includes:

• All ICU nursing and medical notes
• All specialist reports — neurology, cardiology, nephrology
• All blood test results and trends
• All imaging reports (CT scan, MRI, echocardiogram)
• All medication charts
• Any EEG or neurological test results
• All vital sign charts
• All ventilation charts
• all fluid balance charts
• all neurological assessments including your Dad’s Glasgow Coma Scale (GCS)

Do not wait until the end of a hospital stay. Request these records now, regularly, and review them carefully. As a family member, you have the right to this information. If you are struggling to understand what you are reading, that is exactly where we at Intensive Care Hotline can help.

Why Records Matter So Much

Medical records tell you the full story — including information that may not be communicated verbally in a busy ICU. Trends in blood results, neurological assessments, and clinical notes can reveal whether things are improving, plateauing, or deteriorating. Without this information, you cannot advocate effectively for your father. And as a bonus tip, in 2026 in the digital age, getting access to all medical records should be no more complicated than sending you to a URL or a downloadable app with a Username and a password and it should all be there. Any delays in accessing medical records should concern you, is there something the ICU doesn’t want you to see?

Questions You Must Ask the ICU Team Right Now

When you next meet with the ICU doctor or intensivist, here are the specific questions I recommend you ask:

• What is the current neurological assessment of my father? Is he showing any signs of purposeful movement or response?
• Has an EEG been performed? Has an MRI or CT of the brain been done? What did they show?
• Have Somatosensory Evoked Potentials (SSEPs) been performed or planned?
• How is his kidney function trending? Is dialysis (CRRT) being considered?
• What medications is he currently on, and are there any that could still be suppressing his level of consciousness?
• Is he breathing any part of the time on his own, or is he fully ventilator-dependent?
• What is your realistic prognosis for neurological recovery at this stage?
• What is the plan if he does not wake up in the next 7 to 14 days?
• Has a goals-of-care conversation been scheduled with the family and the ICU team?
• Who is the treating intensivist, and can we have a formal family meeting?

How Intensive Care Hotline Can Help Jon and His Family

Jon, you do not have to navigate this alone. Me and my team at Intensive Care Hotline works with ICU families every single day all around the world — families who are exactly where you are right now: scared, overwhelmed, and desperately trying to understand what is happening and what to do.

Here is how we can help you:

• We review your father’s medical records  and help you understand what they mean in plain language
• We prepare you with the right questions before every ICU family meeting
• We can be present — by phone, video or in person — during conversations with the ICU team to help you advocate and push back if needed
• We help you understand treatment options, prognosis, and what realistic recovery could look like
• We support you through goals-of-care conversations, so no decision is made without full understanding

How to Work with Us? Call me on one of the numbers on the top of our website or book a free 15-minute consulting call with me here at http://intensivecarehotline.com/scheduling-appointment/

Or send an email to [email protected]

Visit intensivecarehotline.com to book or call us directly.

If Your Father Cannot Be Weaned from the Ventilator: Intensive Care at Home

While the immediate focus is rightly on neurological recovery, it is never too early to understand what is possible if your father requires long-term ventilation and/or tracheostomy.

If it becomes clear that he is unable to be weaned from the ventilator — whether because of respiratory muscle weakness, diaphragm failure, or ongoing neurological impairment — a tracheostomy may be performed to allow long-term ventilation. At this point, many families are told the only option is indefinite ICU or a nursing home with basic care.

That is not true.

Intensive Care at Home is Australia’s only third-party accredited intensive care at home nursing service. We support ventilator-dependent adults and children to live at home — safely, with dignity, and with full clinical support — instead of spending months or years in an ICU bed.

We provide:

• Specialist Critical Care Registered Nurses (CCRNs) in the home 24 hours a day
• Support for invasive ventilation (via tracheostomy) and non-invasive ventilation (NIV/BiPAP)
• NDIS-funded care pathways for eligible participants
• Care across all states and territories in Australia
• Palliative ventilation support for families who want their loved one to come home for end-of-life care

Even if your father is in the very early stages of ICU recovery right now, knowing this option exists changes the conversation — and the decisions your family may need to make.

Find Out More

Visit intensivecareathome.com or call 1300 921 536 to speak with our team about whether home-based intensive care is an option for your family. Even if you are in the USA, Canada, UK, India or anywhere else around the world, please reach out to us, we can help you there as well!

Summary: What You Need to Do Right Now

• Request all medical records immediately — nursing notes, specialist reports, blood results, imaging, medication charts
• Ask for a formal family meeting with the treating intensivist
• Ask the specific neurological assessment questions listed above
• Have an honest goals-of-care conversation with the ICU team about realistic outcomes
• Do not make any major decisions — including withdrawing treatment — without independent advice
• Contact Intensive Care Hotline if you need an experienced advocate by your side

Jon, your father is fortunate to have a son who started CPR immediately and who is now fighting to understand and advocate for him inside the ICU. Keep going. Keep asking questions. And please reach out to us, we are here to help.

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 in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

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 care.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, 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 cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking 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 in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have 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. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at 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.

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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.