Podcast: Play in new window | Download
Subscribe: Apple Podcasts | RSS
Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
Today, I have an email from Kimberly who says,
“Hi Patrik,
My dad is in ICU and on a ventilator. He can still shake his head and do commands, and he has pneumonia and now he’s got MRSA (methicillin-resistant Staphylococcus aureus). The doctors would like to put in a tracheostomy, and my sister and I know he doesn’t want to be on life support for long. I’m trying to figure out what we should do since his organs are still working. No one has told us they’re failing.”
Well, thank you so much, Kimberly, for writing in.
I do believe there are a lot of misconceptions when it comes to life support in ICU. It should always only be temporary, and it should not be a permanent solution. So, what does that mean?
The first question here that you are missing is, what are they doing to avoid the tracheostomy? What are they doing to get your dad off the ventilator and the breathing tube to begin with? Have they cleared the pneumonia? If they’ve cleared the pneumonia, they should be clearly weaning him off the ventilator as quickly as possible. Stop sedation, stop opiates, and wean him off the ventilator as quickly as possible.
I have made a video about that, “How to wean a critically ill patient off the ventilator and the breathing tube?” I highly encourage you to watch that video or read the article so that you know what steps they need to follow.
Now, one thing is for sure, if you don’t do a tracheostomy and you potentially withdraw treatment, withdraw life support, (a) there’s no guarantee that your dad is going to die depending on where he’s in terms of his recovery. If he is going to die, is that really what you want given that all other organs are still intact?
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. That’s exactly what you are dealing with.
So, getting him a tracheostomy temporarily might be the right thing to do to save his life. Also, now that they need to wake him up, ask him what he wants. There should be no reason why they shouldn’t stop sedation and opiates so that he can wake up and then ask him. It’s one thing to say pre-ICU you don’t want to be on life support, it’s another thing when you are on life support. What do you want next assuming you can make your own decision? Ask him because unless you are in that situation, or unless you’ve seen it with thousands of critically ill patients like I have.
I have been working in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years and where I’ve worked as a consultant and advocate here at intensivecarehotline.com, consulting hundreds, if not thousands of families in intensive care since 2013 at intensivecarehotline.com. I can confidently say that we have saved many lives as part of our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it at our intensivecarehotline.com podcast section where we’ve done some client interviews.
So, Kimberly, it’s a difficult situation to be in, I understand that. But I argue that if your dad can’t come off the ventilator for whatever reason, he needs a tracheostomy to buy him time. Also, so that he can make his own decision. Once he has a tracheostomy, sedation, opiates should be off. He should be more awake, talk to him, ask him what he wants before you’re making any premature decisions that you might regret. Always make decisions today that you don’t regret in 12 months’ time, always do that.
If his organs are not failing, there’s a very good chance your dad can recover. If he’s clearing pneumonia, yes, he’s got MRSA; lots of patients in ICU have MRSA, it’s just one of those things. As long as they treat him with antibiotics, he might be fine.
I would also highly recommend that you let us look at the medical records or that you let me talk to the doctors and nurses directly to find out what’s exactly going on. There’s a lot of information missing from your email. The devil is in the detail when you have a loved one critically ill in intensive care. There’s dozens of things happening simultaneously when you have a loved one critically ill in intensive care, and unless you understand all those details and you connect the dots, it’s an incomplete picture here. It’s a very incomplete picture so we need more information. But don’t make any hasty decisions and make decisions that you do not regret in 12 months’ time, 24 months’ time, God forbid, if your dad would not survive because there’s no return and no coming back from that.
Now, because we get so many questions for families in intensive care, that’s why we created 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. Those eBooks and videos and all the resources will help you to make informed decisions, have peace of mind, control, power, influence, making sure your loved one gets best care and treatment so that you can influence decision making fast.
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 and 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 so that in case 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 simply send us an email to [email protected] with your questions.
If you like my videos, 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 the 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 our 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)?