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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is about a question from Brenda who says,

“Hi Patrik,

My dad is in ICU, and he is full code. The ICU team is telling my sister that it’s best if she switches to a DNR (Do Not Resuscitate) due to his heart. The doctor is saying that since his heart is bad that doing CPR (Cardiopulmonary Resuscitation) would only put my dad in more pain and suffering. Can you please help?”

Brenda, that’s a great question. I’m very sorry to hear about your dad’s situation.

Let’s just break down some terminology here first. DNR stands for Do Not Resuscitate. Another term for that is NFR, not for resuscitation. Both terms are interchangeable, but at the end of the day mean the same that if the heart stops for a patient in a hospital, and we’re mainly talking about ICU here, that the ICU team or the medical emergency team will not start resuscitation or CPR. CPR stands for cardiopulmonary resuscitation, which is basically starting cardiac compressions in the event that the heart stops and also giving other life-saving medications for following the CPR algorithm. I’m not going into detail here about the CPR algorithm right now.

But let’s just look at your dad’s overall situation and let’s just look at the bigger picture of what’s happening in intensive care in general, in those situations.

So, most ICUs take that approach that they do want people with a DNR. Why is that? The biggest challenge for an intensive care unit is to look after a patient indefinitely with an uncertain outcome. Many patients that have CPR represent that worst-case scenario for intensive care teams.

Why is that? If you do CPR on a patient, they often end up back on a ventilator that end up back in an induced coma. They end up back on inotropes or vasopressors. They might end up in kidney failure, they often end up with infections. So, the list of things that keeps them in ICU for long periods of time is pretty long.

So, what does Brenda mean when she says the doctor is saying that since his heart is bad doing CPR would only put my dad in more pain and suffering? Look, when someone has CPR, I totally agree, and I have been in many CPR situations in ICU myself with patients. It is not pretty, it is not pretty at all. I fully agree with that. It is not a pretty situation. It is a full-on situation where everyone needs to be on their toes where everyone needs to know what to do in those difficult situations.

Now, is CPR causing pain and suffering for a patient? Absolutely yes. Absolutely yes. Is there pain and suffering involved recovering from CPR? Absolutely yes. It’s not straightforward, but life in general is often pain and suffering. We’ve all been through pain and suffering, sometimes physical, sometimes mental, but we’ve all been there to say anything less would simply be a lie.

So, what’s the cost of living? The cost of living is often pain and suffering. So, I always disagreed with the notion of that CPR causes pain and suffering and you’re breaking a few ribs. That is all accurate, that is all accurate. I’m not denying that for a minute, but it is up to the individual to make that choice, not up to intensive care teams to paint a doom and gloom picture before it’s even happened.

The reality also is that CPR has saved many, many lives. So, it is really a debate that needs to be opened and both sides need to be heard. At the end of the day, it is a person’s life that is at stake here. You could argue, let’s not go through pain and suffering and let the person die but what if the person doesn’t want to die? What if the family doesn’t want their loved one to die? In most jurisdictions, it’s up to the family, not up to the intensive care team.

So, we should be less judgmental, and we should be listening to both sides, and then make a decision from there. But at the end of the day, I’m such a big believer of “It is my body, my choice”, and it is up to the individual or the family in many situations where patients in ICU can’t speak for themselves to make that decision.

I strongly disagree that pain and suffering is not worth living because that’s basically what some intensive care teams are saying. It’s worse to cause pain and suffering than to live. It is a debate that needs to be had. But I strongly believe that it is up to a person, whether they want to live or up to the family, if the person can’t speak for themselves. I feel very, very strongly about that.

So, that is my quick tip for today.

Because we get so many questions for families in intensive care daily, that’s why we created a membership for families in intensive care. You can get access and become a member for of our membership for families of critically ill patients in intensive care at 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.

You also have access to 21 videos and 21 e-books that I have personally written and recorded for you. Those e-books and videos will help you manage this incredibly difficult territory that is intensive care, and 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.

I have worked in critical care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care all around the world since 2013.

I can say without the slightest hint of exaggeration that we have saved many lives with our consulting and advocacy, you can look up our testimonial section and you can also look up our podcast section where we have done client interviews to verify what I am saying here.

I also offer one-on-one consulting advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I also talk to you and your families directly. I talk to doctors and nurses directly and you will see that when I talk to doctors and nurses directly that the dynamics will change in your favor because then the intensive care team knows you have someone on your team who understands intensive care just as well as they do. I also represent you in family meetings with intensive care teams if you want me to.

We also offer medical record reviews in real time so that you can get a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply 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].

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, share the video with your friends and families.

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Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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