Quick Tip for Families in Intensive Care: My 81-yr-old Husband’s in ICU Ventilated & Tracheostomy, Dialysis, Liver Failure, ICU’s Pushing Palliative Care!
Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So, today’s tip is another question answered from one of our readers who says, “Hi, Patrik. My 81-year-old husband, John, has osteomyelitis and he developed a sacrum pressure sore complicated by pseudomonas and he now has pneumonia from the ventilator. He has had a tracheostomy in the last few days. He’s on 24-hour hemodialysis. His kidneys are producing zero urine from an acute kidney injury. His liver is faltering causing ascites so PEG tube cannot be placed. He’s barely holding his own, I suppose from the induced coma. His eyeballs do not see me anymore. The ICU team is pushing for palliative care. Can you help me?” Absolutely, can I help you. That is from Ingrid.
So, Ingrid, here’s the thing. First off, if your husband has a tracheostomy, he should not be in an induced coma. One of the purposes of a tracheostomy is to reduce and eliminate sedation and opiates because a tracheostomy is so much easier to tolerate than a breathing tube in the mouth. No patients really need any sedation if they’re having a tracheostomy. So, that’s the first thing.
That brings me right back to what I’ve been saying for the longest that 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 exactly what you are dealing with here, Ingrid, that if your husband has a tracheostomy, he does not need any sedation.
Number two, if he’s been in ICU for a couple of weeks, why does he have a tracheostomy? Have they done everything beyond the shadow of a doubt to avoid the tracheostomy, get him off the ventilator and the breathing tube in the first place? Again, the biggest challenge for families in intensive care is simply that they don’t know what they don’t know.
Next, if he has osteomyelitis and the sacrum pressure sore, that is clearly negligent from the hospital. No patient in the hospital must ever sustain a pressure injury or a pressure sore. That is negligence. If the nurses were doing all the right things by doing regular turns, doing regular washes, skin inspection, get your husband on a soft mattress or on an air mattress, this should have never happened to begin with.
Next, if he’s on hemodialysis for kidney injury, then that’s probably temporarily. Most patients in ICU need the dialysis machine temporarily for septic shock or for any other acute kidney injury, which is what’s happening here. It’s often temporary from my experience.
If his liver is faltering and it’s causing ascites, have you asked for albumin levels? Very likely your husband’s albumin levels are low. Are they replacing albumin? You also shouldn’t concern yourself about the PEG (Percutaneous Endoscopic Gastrostomy) tube. Your husband doesn’t need a PEG tube. I have made countless videos on why patients in ICU do not need a PEG tube. PEG tube has its time and its place, but often not in ICU directly.
Also, if he has a kidney injury and his liver is not working, have they consulted the specialists? Have they consulted renal specialist? Have they consulted a liver specialist? Or are they trying to manage it all by themselves?
Lastly, don’t concern yourself with ICU wanting to move towards palliative care. It is your decision and your decision only what you want for your husband, assuming your husband can’t speak for himself. So, it is your decision and your decision only. No one can force you towards palliative care. Keep that in mind. Also, try and get your husband out of the induced coma as quickly as possible.
Now, the quickest way forward here is really by talking to me directly, I can talk to the doctors and nurses directly. I will ask all the questions that you haven’t even considered asking but as you can see, must be asked for you to make informed decisions, and get peace of mind, control, power, and influence because I can see you’ve got none of it because you haven’t asked the right questions yet.
So, that is my quick tip for today.
I also represent you in family meetings with intensive care teams. I’m your clinical sounding board. I’m your consultant and advocate in family meetings with intensive care teams. So, you’re not getting into those situations in the first place. So, that is what’s happening here.
We also have a membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions, intensive care related.
As I said, I do one-on-one consulting over the phone via Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to doctors and nurses directly asking all the questions you haven’t even considered asking.
I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over five years. I’ve been consulting and advocating for over 10 years for families in intensive care, all around the world. Just have a look at our testimonial section and some of the interviews that we’ve done with our clients.
We also offer medical record reviews in real time so that you can have a second opinion in real time, but also about me talking to doctors and nurses directly and holding them accountable. It’s also giving you a second opinion. We also provide medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.
But the much better option is to get help early on when your loved one is in intensive care so you’re not getting off on the right track like Ingrid, for example. I’m glad she’s reaching out now, but the sooner you will know what to do, what to look for, and what questions to ask, the better it is.
Also, if you need help, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].
Also, for access to the membership, go to intensivecarehotline.com, click on the membership link or simply go to intensivecaresupport.org directly. As I said, you can talk to me directly. I offer one-on-one consulting and advocacy.
Now, thanks for watching.
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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.