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Today, I have an email from Angel who wants to know whether his brother with a cardiac arrest in ICU is getting best care and treatment. If you want to know the answer to that, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and this is another quick tip for families in intensive care.

Angel writes,

“Hi Patrik,

My older brother, he’s 40 years of age. He had a cardiac arrest on March 9th, around 7 to 8 p.m. I have seen many of your videos on YouTube. My brother opened his eyes the following Saturday. We haven’t really been shown any concrete studies and results of the severity of his condition. Yet, last night, before leaving, the nurse suggested to have a conversation with the consultant about options. Like you say in your videos, they have been very negative all the way along. My brother’s case is quite complicated and complex due to him also needing dialysis for kidney failure. Yet, we as a family, will not lose faith. He’s a fighter and has endured a lot of hardships and pain in his life. I don’t really have just a question, yet many. We believe in miracles and the work of God, yet your informative ICU background can really help us. Thank you so much. I’m looking forward to speaking with you.”

Angel, I’m very sorry to hear about your brother’s condition. 

Like I always say, 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. 

Let’s just quickly look at, first off, what is the best care and treatment for patients in ICU after cardiac arrest? Immediate post-cardiac arrest care requires ventilation and oxygenation. Most patients need ventilation to support breathing and ensure adequate oxygen supply. Most patients also require blood pressure support after cardiac arrest with IV fluids, vasopressors, or inotropes or other medications to help maintain blood circulation. They also need active cooling, also known as targeted temperature management, and cooling the body to 32 to 36 °C, which is 89.6 to 96.8 °F, for 24 to 48 hours reduces brain damage from hypoxia.

(1) Neurological monitoring and care, sedation and pain management medications like propofol or fentanyl can keep the patient comfortable. Electroencephalogram (EEG) monitoring for seizures which are common after cardiac arrest. Angel, you haven’t mentioned anything about your brother having seizures, but you need to ask that question again. You didn’t even have asked that question on your radar.

(2) Pupillary and reflex checks help assess brain function. Imaging, CT and MRI detect brain swelling or injury. It sounds to me like they’ve done that. 

(3) Cardiac and circulatory support. ECG (Electrocardiogram) monitoring goes without saying, detects arrhythmias or heart damage, potentially leading to another cardiac arrest. Echocardiogram evaluates heart function and damage, also known as an ultrasound of the heart. Coronary angiography, if a heart attack caused the arrest, doctors may perform an angioplasty or stenting or simply an angiogram to see where the blockage occurred.

(4) Infection prevention and management. Antibiotics are given if pneumonia or sepsis is suspected. Frequent suctioning and oral care prevents ventilator-associated pneumonia.

(5) Organ support and kidney function monitoring. Acute kidney injury is common after cardiac arrest. Dialysis may be needed and was needed prior to your brother going into cardiac arrest even.

(6) Gastrointestinal support. A feeding tube, nasogastric tube or PEG (Percutaneous Endoscopic Gastrostomy) tube may be placed if prolonged ventilation is needed. However, we object to a PEG tube. A nasogastric tube will be perfectly fine. 

What are long term considerations? Tracheostomy might be required if prolonged ventilation is needed, but you should also be planning for rehabilitation. If recovery is possible, early rehabilitation begins with passive movement and positioning. Of course, the intensive care team need to have a family discussion with you to look at prognosis, treatment goals and the possibility of getting your brother back on his feet as quickly as possible. 

What’s the prognosis and decision making like in a situation like that? Recovery may depend on factors like initial heart rhythm, downtime before resuscitation, response to treatment and brain function tests. Some patients regain consciousness within days while others remain in a minimally conscious or potentially vegetative state but can still come out of that after weeks and sometimes months.

So, I hope that helps you understand, Angel, what your next steps are, but what is also really important for you to know is you need access to the medical records as quickly as possible. Like you said in your email, you mustn’t lose hope. While hope is not a strategy, it is still important not to lose hope. Get a second opinion, get consulting and professional advocacy like we do here at intensivecarehotline.com where we give you a second opinion, where we give you strategies to deal with intensive care teams in situations like that so they’re not continuing in giving you all the negative news without putting the steps in place to help your brother recover. 

That’s why you need to get access to the medical records as quickly as possible. That’s why you need myself and you to get on a call with the doctors or with the senior nurse as quickly as possible so we can ask all the right questions so that you make informed decisions, have peace of mind, control, power and influence, making sure your brother gets best care and treatment always. 

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 critical care. I have been consulting and advocating for over 12 years here at intensivecarehotline.com since 2013.  I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that on our testimonial section at intensivecarehotline.com or you can verify it on our intensivecarehotline.com podcast section where we have done some client interviews.

My advice and the advice of my team is absolutely life changing, and that is no exaggeration by any stretch of the imagination. It’s all documented on our podcast section and on our testimonial section. Our advice is life changing, because if you’re not getting advice, you simply don’t know what you don’t know. That is the biggest challenge, you don’t know what you don’t know. The sooner you find out what you don’t know, the better the outcomes you will be getting.

You can join a growing number of members and clients that we have helped over the years, once again, to improve their lives instantly, making sure their loved ones get best care and treatment always by making sure they make informed decisions, have peace of mind, control, power, and influence. 

That’s why I 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 cannot afford to get wrong. I also talk to doctors and nurses directly, and I ask all the questions that you have not even considered asking but must be asked when you have a loved one critically ill in intensive care. When I talk to doctors and nurses directly, you will see the dynamic shift in your favor in real time, because I know how to hold them accountable. I know what questions to ask them, not even seeing the questions coming off. 

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 you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com where we also have a membership for families of critically ill patients in intensive care. 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 e-books and 21 videos that I have personally written and recorded that are only exclusively available to our members. 

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 [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, what questions and insights you have, and share the video with your friends and families.

I also do a weekly YouTube Live where I answer your questions live on a show. You will get notification for the YouTube live if you’re a subscriber to my YouTube channel, or if you’re a subscriber to my intensivecarehotline.com 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.

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