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If you want to know how to avoid your critically ill loved one dying in intensive care, stay tuned! I’ve got news for you.

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

I have an email today from Catalina who says, 

 “Hi Patrik,

I’m reaching out for closure. I’m still in the process of requesting my father’s medical records, which I can send over to intensivecarehotline.com as soon as I have them. I know they won’t change that my father is gone, but I’m struggling to come to terms with my decision to have placed my father on comfort care. 

My father was admitted to ICU on February 7th at 8:00 a.m. He was 61 years of age with a history of diabetes and mental illness. He was diagnosed with H1N1, pneumonia, and he was found to have two secondary bacterial infections in his lungs and blood: Pseudomonas and Staphylococcus. He went into septic shock and his kidneys were failing. Moreover, he was intubated and on a ventilator. 

I flew out to see my father on February 8th and arrived at about 6 a.m. My father was mottling on his thighs, with purple/blue coloring on his feet, hands, ears, and face. He was very cold to the touch. The doctors informed me he wasn’t showing signs of any reflexes and that he was on the highest ventilator settings (it was adjusted the night before to the highest setting). 

They informed me his fever, blood pressure, etc. had not changed despite their interventions. They told me they wouldn’t leave the interventions running for him to the 9th of February, and that they would allow me to decide when to place him on comfort care.

I did feel that the ICU team for the most part was very responsive to our family, answering our questions to the best of their ability. But when I look back on it now, I feel like they were telling me I didn’t have a choice about transitioning to comfort care- I just had a choice about when. 

My gut told me my father was dying, based on what I could see, and maybe I’m just struggling to accept that, but I feel guilty that I did a “euthanasia” as stated on your website, without fully knowing that that’s what comfort care was/meant, and that I didn’t ask enough questions. 

Can you please shed some light on this situation? I really appreciate your support.”

Catalina, I’m very sorry to hear what weight you’re carrying, and I want you to know that what you’re feeling is very much understandable. Making a decision like this for your father, especially in such a critical and heartbreaking situation, where you couldn’t be there right from the start is one of the hardest things anyone can go through. 

From everything you shared, it sounds like your dad was in multiorgan failure, septic shock and his body was shutting down despite some interventions, whether they were aggressive or not, that is what we would find out in the medical record review. 

The mottled skin, the extremities turning blue, and the unresponsiveness all suggests that his circulation was failing, however, again, what was leading up to it? Could they have started intervening earlier? Did they give him all treatment options available prior to you and your family even showing up there? It looks like it wasn’t just the ventilator keeping him alive, it was probably a combination of multiple life supporting measures including inotropes, vasopressors, and maybe even blood products. 

Even though it wasn’t reversing what was happening, but the question is, was it too little, too late? The question is, what happened leading up to it? The other thing that you need to know, intensive care teams often frame comfort care as a choice. But in reality, they want to just make it look nice for you and really tell you, “Tomorrow at 3 o’clock, we’re going to withdraw life support.” Whilst in your dad’s situation, by the time you arrived there, it sounds like it was a real and not a perceived end of life situation.  Once again, the question that I’m having is, what they were doing leading up to it?

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’re dealing with here. 

Because the question is, with him having diabetes, and he was diagnosed with H1N1 and a pneumonia, and having two secondary bacterial infections and his lungs and his blood, were they giving him the proper antibiotics? Were they starting them early enough? Were they’re following through the whole course? Then, he went into septic shock and his kidneys were failing. Did they give him the appropriate septic shock treatment? Did they give him the right antibiotics? Did they give him the steroids? Did they start him on hemodialysis or hemofiltration?

So, the question is, what did they do before the time that you showed up there? Did they do all the right treatment? When hospitals frame that comfort care is your choice, what they’re really saying is, “Well, we’re going to do comfort care anyway. You can just and decide the time.” Comfort care should be a choice, not a situation where it’s being forced on you.

Approximately 90% of intensive care patients survive, assuming all the things are being done. Maybe all the things were done, I couldn’t tell you. But if the things weren’t done, that’s what we need to find out in the medical record review.

Was it euthanasia? Once again, I don’t know. Did they use morphine, midazolam, sedation, opiates to hasten death? Then, that is euthanasia. But comfort care as such doesn’t cause death, but the withdrawal of life support or the removal of life support can cause death, unless even full measures of life support will not keep someone alive. That’s also then when it’s a real and not a perceived end of life situation. 

The other question is, what was their bed status or their bed situation in ICU? Did they need a bed? Did they have enough staff? Did that compel them to potentially end your father’s life quicker? No guarantee your dad would have survived if they had done all the things from the start. Once again, maybe they have done all the things from the start, but that’s what the medical record review will do for you. When we look at it, we will find out.

The other thing that is important to note here is, for anyone in a similar situation, you need to ask for help from Day 1, because now we’ve got Catalina here who’s absolutely guilt ridden. She’s absolutely guilt ridden by what’s happened. You need to ask for help from Day 1. If you’re not asking for help, this is when you end up in those situations. If you had consulted with me and we would have given you a second opinion. Maybe we would have told you this is a real end of life situation, not a perceived end of life situation. 

Doing everything within their power, but now you need to do a medical record review, and until that’s complete, you’ve got to live with a lot of guilt. Guilt is a natural part of grief, especially when forced into impossible decisions. But what is an impossible decision? An impossible decision is only “impossible” if you don’t know what to do. That is what we are here for. We show and help families in intensive care what the best courses of action are so that you will make informed decisions, have peace of mind, control, power, and influence whilst you were there for your dad in the dying hours. Leading up to it, all the right questions should have been asked. 

I know words will not take away your pain. I hope that you can find some peace and clarity, but we will help you with that by looking at the medical records of your late father and getting some peace and clarity. 

The bottom line really is, for anyone watching this, do not get in a situation like that. Get help the minute your family member goes into ICU. Because the reality is, when someone is critically ill in intensive care, there are dozens and dozens of things happening simultaneously. It’s like piecing together a very complex puzzle, and unless you understand all the moving pieces, you will be led down the wrong path because you will not be in a position to make informed decisions.

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. I’ve been consulting and advocating for families in intensive care since 2013. I can very, very confidently say we have saved many lives with our consulting and advocacy. 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 client interviews. Those client interviews will show you and will verify with you that we’ve saved so many lives. It’s part of our skill.

No guarantee we would have saved Catalina’s father’s life, but chances would have been much higher for that to happen if she had reached out on Day 1 of her father going into ICU. Don’t make the same mistake, reach out on Day 1 because our advice here is absolutely life changing. Again, that is no exaggeration. It’s no exaggeration, our life advice is absolutely life changing. We have changed so many lives to the better, and we have saved lives. 

You can join a growing number of clients and members with one-on-one consulting or as part of our membership, because I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever meeting works best for you. I talk to you and your families directly. I talk to doctors and nurses directly. I handhold you through this once in a lifetime situation that you cannot afford to get wrong. I also talk to doctors and nurses directly on your behalf or with you, or I set you up with the right questions to ask depending on your situation, then you will see the dynamics change in your favor. I will 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 if you need closure, if you are suspecting medical negligence, or if you are needing closure.

We 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. We answer all questions intensive care related and we break things down for you in Layman’s term so that you can understand what’s exactly going on with your loved one in intensive care.

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, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have.

I also do a weekly YouTube live where I answer your questions live on the 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.