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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 an email we had from a reader, and Shirley says, “My daughter has been in intensive care on the ventilator for three weeks now. They have inserted a tracheostomy. However, they have started to wean her off the ventilator slowly, step-by-step. And my biggest concern, however, is she’s not waking up even after three weeks. She initially went into ICU with a pneumonia.” So, what’s probably happened here, Shirley, is that your daughter was probably in a prolonged induced coma. You haven’t shared how old your daughter is. You haven’t shared whether your daughter has any pre-medical history. You’ve shared basic but good information. So, let’s break this down.
So probably, your daughter has been in a prolonged induced coma until they’ve decided that they need to do a tracheostomy. They didn’t obviously see any other choice to wean her off the ventilator, and now she’s taking her time to wake up. I would hope that she’s off all sedation, that she’s off all pain medications such as morphine or fentanyl, also known as opiates. Make sure that’s the case because if she’s still on any sedatives or opiates, that might be one of the reasons why she’s not waking up.
Now, other things that they should be checking for, assuming she’s off all sedation, have they done a neurological consult? Have they got any neurology input? For example, have they done a CT scan of the brain and MRI scan of the brain? Have they done an EEG (electroencephalograph)? What else is going on? Why is she not waking up?
Other issues that you might want to consider is, is she potentially in kidney failure? Is she in liver failure? So, for example, if she’s been off sedation for a few days, but she’s still not waking up, if the kidneys are not working, are sedation and opiates being excreted through the kidneys? Or if her liver is impaired, is she not metabolizing sedatives and opiates? So, those are other issues that you need to consider.
Next, sometimes patients in intensive care simply don’t wake up because they’re sick and they take their time to recover. Now, keep in mind that interacting with people can cost a lot of energy, especially when you’re ill and people just can’t handle it yet and they’re just being asleep. So, just something for you to consider as well.
Now, if God forbid, she can’t come off the ventilator and the tracheostomy and it’s going on for too long, you should be looking at options such as Intensive Care at Home. So, for long-term intensive care patients, if they are stuck in intensive care with long-term ventilation, tracheostomy, and the likes, also home TPN (181) or non-invasive ventilation, your daughter can go home with our service Intensive Care at Home. So, go to intensivecareathome.com and find out more information there.
We are currently operating all over Australia, and if you are in the U.S. and you’re watching this, you should contact us as well. We can help you in the U.S. as well by sending you to other services.
That is my quick tip for today.
If you have a loved one in intensive care, call us on one of the numbers on the top of our website at intensivecarehotline.com or simply send us an email to [email protected].
Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in membership area and via email, and we answer all questions, intensive care and Intensive Care at Home related.
Now, if you need a medical record review for your loved one in intensive care, we can provide that for you in real time so you have a second opinion in real time, and we can break things down for you in real time and also in a language that you can understand. And also, we are really dedicated towards that. The doctors in intensive care and the nurses often don’t have the time to talk to you and explain things in detail or they even don’t want to talk to you. We see that as well. And we also review medical records after intensive care, if you’re suspecting medical negligence, if you have unanswered questions, or if you’re simply needing closure of what’s happened.
Subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the notification bell, and comment below what you want to see next, or what questions and insights you have from this video.
Thanks for watching.
This is Patrik Hutzel from intensivecarehotline.com and intensivecareathome.com, and I’ll talk to you in a few days.