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If you want to know what to do if your brother is in ICU on a ventilator, unconscious with seizures for 2 weeks, but it’s not brain dead, and can you ask for more time to make a decision and delay end of life support? Stay tuned. I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com and I’ve got another quick tip for families in intensive care today.

So today, I’ve got an email from Wendy who says, “Hi Patrik, my brother is in ICU on a ventilator, unconscious with seizures for 2 weeks, but he’s not brain dead. Can I ask for more time to make decisions and delay end of life support?”

Well, that’s a great question, Wendy, and I’m glad you’re asking me. I’m very sorry to hear what your brother is going through.

So, the question is, what has been leading up to this? Why is he unconscious? Is he unconscious because he’s got severe brain damage? Is he unconscious because he’s in an induced coma, i.e. he’s on sedatives and opiates? Especially with your reference, that it’s not brain dead. 

It is very important that we distinguish between some terminology here. There’s a big difference between someone being brain damaged and someone being brain dead. If someone is brain dead, they’re often considered legally dead in some jurisdictions and I’m not putting any judgment on that. It’s just what some jurisdictions say that someone who’s been diagnosed with brain dead is also legally dead.

So, the question is, again, why is he unconscious? Is there any significant brain damage? If so, where is that coming from? Where are the seizures coming from? Is a neurologist involved? Have they done an MRI (Magnetic Resonance Imaging) scan of the brain, a CT (Computed Tomography) scan of the brain, an EEG (Electroencephalogram) of the brain?

You can absolutely ask for more time to make a decision. If he’s not coming off the ventilator and you want to “buy “him time, does he need a tracheostomy? Because if he can’t be weaned off the ventilator, then he needs a tracheostomy, assuming you want to prolong his life and you want to give him a chance.

If that is the case, then you should absolutely be advocating for a tracheostomy, full stop. I would do the research if I was you, because let’s just say your brother is in an induced coma with opiates and sedatives going in, and he’s on a breathing tube but he ends up with the tracheostomy, one of the main reasons one needs a tracheostomy, or a patient needs a tracheostomy is to wean sedation, wean opiates, and let patients wake up, and that is so much easier with the tracheostomy.

So, the question is, have you considered that? Has that been given to you as an option? If it hasn’t been given to you as an option, check out our articles at intensivecarehotline.com, such as “How long can a breathing tube or endotracheal tube stay in?” “How long can a patient be ventilated before needing a tracheostomy?” Check those articles and videos out. They will answer some of your questions there.

I also think you might want to start thinking about what are treatment options for your brother, potentially, instead of thinking about end of life. Have you had a conversation with the intensive care team about treatment options? Are there any? Have you spoken to the neurologist? What has led to all of this?  Has he had a cardiac arrest? You need to speak to the cardiologist, make sure this is not happening again. What would be acceptable for your brother in terms of quality of life, if he was to come through this, what would be acceptable for him to live?

Now, can you ask for more time to make decisions and delay end of life support? Absolutely, yes, no one can hurry you to kill your brother. What’s the hurry to kill a patient in intensive care? Where’s the urgency? So, that’s a very relevant question here, what is the urgency to kill someone? There should be an urgency to help your brother and get him to improve. Again, I don’t know whether that’s possible or not, and I can’t comment on that, but that should be the emphasis here to help your brother.

So, in terms of delaying end of life support decision making, well, once again, this is not up to the hospital. It’s up to you, assuming you are the next of kin or power of attorney It’s up to you, not up to them. 

So, the question that you also need to ask is, if you let your brother go and let him die, you know the outcome. If you don’t let him go, you don’t know the outcome. Yes, there’s a lot of uncertainty, but there’s also plenty of time to talk about end of life.  Plenty of time to talk about end of life. Once again, what’s the hurry and the rush to kill someone?

Also, make decisions today that you don’t regret in 12 months’ time. So, what that means is if you were to agree to let your brother go today, would you be satisfied with that? Would you be regretting that in 12 months’ time potentially? You may not regret it today, you think it might have been the right decision today, but do you potentially regret that in 12 months’ time. Very relevant question, very relevant question. So, keep that in mind. Make decisions today that you don’t regret in 12 months’ time.

So, I have worked in critical care nursing for 25 years in 3 different countries where I worked as a nurse manager for over 5 years and where I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say we have saved many lives with our consulting and advocacy, and you can verify that on our testimonial section, see what our clients say. You can verify it on our intensivecarehotline.com podcast section where you can watch and listen to client interviews to listen to what they say, how we help them.

We have helped hundreds of members and clients over the years to help their loved ones in intensive care, including saving their lives where intensive care teams told them they would be dying and when we looked at medical records, for example, we saw, no, they’re not dying, they’re just making this up to keep the upper hand. It’s all about psychology in intensive care, and you need to understand the psychology.

Like I said, we have helped hundreds and hundreds of members and clients over the years to help their loved ones improve in ICU and save their lives as well. That’s why we also created 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.

I do one-on-one consulting and advocacy on the phone, Zoom, WhatsApp, Skype, 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 directly with you or on your behalf. When I talk to doctors and nurses directly, 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 and you will see that the dynamics change fast once I speak to doctors and nurses because I can hold them accountable. 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. 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 from this video.

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 are a subscriber to my email newsletter or if you are a subscriber to my intensivecarehotline.com YouTube channel here at YouTube.

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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