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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today, I want to read out an email from a reader and David says, “I feel like we don’t get straight answers from anyone about my father’s current condition and prognosis following two cardiac arrests, two strokes, two blood clots in his lungs, respiratory arrests times two. No response, but related to his health or because of the sedation for ventilation? How do we know what to ask when we ask for care conference to know if he’s just being kept alive to suffer more?” What a great question. I’m very sorry, David, to hear about your dad’s situation.

Again, the biggest challenge for families in intensive care is that they simply 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. And that’s exactly where your question is coming in. You are very much asking the right questions here about what to look for but how do you ask those very specific questions in such a highly complex situation?

It sounds to me like your dad has at least gone into double organ failure, i.e., he had a cardiac arrest, he had a respiratory support to the heart, and the lungs are failing, which means he’s probably on life support for the lungs. Definitely. He’s on a ventilator. You already shared that. He’s probably on life support for his heart as well with inotropes and or vasopressors. He might have had an angiogram or an angioplasty. You haven’t shared that he might even had cardiac surgery. You haven’t shared any of that how they intervened, especially with a cardiac arrest. Then, he also had two strokes and two blood clots in the lungs. Blood clots in the lungs are generally speaking, to refer to as pulmonary embolism. He’s probably also on a heparin infusion now to break down the clots and prevent clots going forward. So, he’s very complex here.

Now, you are referring to a case conference, also known as family meetings. What should you be asking? Especially you’re making reference, is he just being kept alive to suffer more? Those are all relevant questions. Now, two questions here for you, David. Does your dad have an advanced care directive? Has he documented with his GP (General Practitioner) legally what he wants in a situation like that? Because your answer might just be within an advanced care directive. If the advanced care directive is not there, that document doesn’t exist, then you might think about a time when you spoke to your dad about what he would want if a situation like this occurs, and that should be your guidepost.

Now next, care conference, you as a next step should be asking the intensive care team for a written agenda for the care conference. You want to know what they want to talk about. Don’t go in their blind. Any business meeting has a written agenda, generally speaking. So, this is a life-or-death situation, and you are saying, there should be no agenda? So, you should definitely be asking for a written agenda before you go into any meeting.

Is he being kept alive to suffer more? Again, I cannot answer that question without having more detailed information. How severe the strokes? How severe was the cardiac arrest? What are his ventilator settings? What medication is he on? Has he had a CT (Computerized Tomography) scan of the brain? MRI (Magnetic Resonance Imaging) scan of the brain? What’s the neurologist saying? Does he have seizures for example? Those are all the questions that need to be asked, and sometimes, time is a healer in ICU. There’s no guarantee.

It looks about what you’ve shared, that the prognosis might be poor. But again, you don’t want to prematurely withdraw treatment either. You need to really dig deeply in terms of what’s best for your dad. What does he want? Talk to a neurologist and a cardiologist in particular and see what they say. Is it realistic for him to get off the ventilator? Does he need a tracheostomy? You mentioned he’s been in ICU for five days. So many, many unanswered questions. But we can help you deciphering all of it. We can help you with asking all the detailed questions. We can help you talking to the doctors. We can represent you in a family meeting. Remember, get a written agenda and we can also review medical records. We can do a combination of all of that.

So, that is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com and call us on one of the numbers on the top of our website, 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 in a membership area and via email, and we answer all questions intensive care related there.

If you need a medical record review, you should contact us as well. We review medical records for our clients in ICU and also after ICU, especially if you suspect medical negligence.

Thanks for watching.

Subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, 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 I’ll talk to you in a few days.