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If you want to know what to do when your loved one is on a ventilator in intensive care after 4 weeks of being a patient 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.

So today, I have an email from Mandy who says,

“My husband has been in intensive care for 4 weeks and he’s still on the ventilator. What should I do?”

Well, Mandy, I’m very sorry to hear that.

Now, what do I keep saying over and over again? 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, which is exactly what Mandy is dealing with here.

So, Mandy, if your husband has been on the ventilator for 4 weeks in intensive care, why is he on a ventilator? That is the very first question that would need to be answered here. Why is he on a ventilator because he was in a car accident? God forbid. Is he on a ventilator because he had open heart surgery? Is he on a ventilator because he has a pneumonia? Why is your husband needing a ventilator? Is he being septic?

The more information when you send an email, the better, but you wouldn’t even know what questions to ask. I understand that because it is so foreign and strange for families in intensive care to just look at their family members, not really understanding what’s going on.

The next question here is, is your husband ventilated with a breathing tube in the mouth or in the nose? Or is your husband ventilated with a breathing tube with a tracheostomy in the neck? There a lies a very big difference. The difference is that simply if your husband is still ventilated with a breathing tube after 4 weeks, and ultimately, he’s most likely sedated with sedatives and opiates such as morphine, fentanyl, or sedatives such as propofol, midazolam/Versed, or Precedex, and that has its own risk and its own side effects. The sooner your husband can get off those sedatives and opiates, the better.

Now, let’s just quickly look at tracheostomy. If your husband has been ventilated for more than 2 weeks, and he hasn’t come off the ventilator or he couldn’t come off the ventilator, he absolutely needs a tracheostomy. So, big red flags if your husband is still ventilated with a breathing tube and in an induced coma, that should not happen.

If your husband is having a tracheostomy, like I said, they should have done that after about the 2-week mark, then, he should be off sedatives, he should be off opiates because the tracheostomy is so much easier to tolerate compared to a breathing tube. So, he should be of all sedatives, and they should have started physical therapy by now. They should have started to mobilize him. They should have started to mobilize him, get him out of bed.

Now, there’s a number of reasons why someone can’t get out of bed in intensive care when they have a tracheostomy. One of them is if they’re having fractures and they’re waiting for surgery or they simply can’t be moved because of fractures, or they’re hemodynamically unstable and they have an inability to move because of that. Their blood pressure fluctuates, their heart rate is irregular, they’re unstable, that’s when they can’t get mobilized.

Other than that, with your comment that your husband is going to week 4 and he’s still on the ventilator, he should simply be getting mobilized, physical therapy. That’s the only thing that gets someone off the ventilator. I don’t understand why people don’t use common sense. The number of people in intensive care that stop using common sense is unbelievable to me.

How do you think your husband will get off the ventilator if he’s not getting moved? It’s like saying, “Oh, I’m going to run a marathon next week, but I haven’t trained for it.” When someone is on a ventilator, especially prolonged ventilation in intensive care, they need to, unfortunately, retrain their breathing muscles. They need to regain the strength in their breathing muscles. That’s not going to happen without any mobilization, sitting upright, strengthening breathing muscles. It’s not going to happen otherwise.

Always use common sense. Don’t let intensive care team persuade you not to use common sense because what they’re sometimes trying to do. Mobilizing a patient and getting out of intensive care is actually common sense.

So, I hope that explains, Mandy, what needs to happen next.

But for anyone that writes in, you need to give us as much information as possible because, basically, by you saying, “My husband is going to week 4 and he’s still on the ventilator”, that gives me probably 2% of what I need to know. When someone is critically ill in intensive care, it is a very, very complex situation. We need to look at all elements of the moving pieces when someone is in intensive care, whether it’s ventilation settings, whether it’s arterial blood gases, whether it’s blood results, medications, your family member is on, and the list goes on.

That’s why you need expert advice when you have someone critically ill in intensive care because, once again, 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.

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. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients in intensive care, and that is verified and documented on our testimonial section at intensivecarehotline.com. It’s verified and documented at our intensivecarehotline.com podcast section where we have done client interviews. I can very confidently say that we have saved many lives over the years, and we continue to save lives with our consulting and advocacy. We can do the same for you because our advice is absolutely life changing without the shadow of a doubt.

If you talk to me directly, I will uncover things for you that you didn’t even know you didn’t know, but you need to know them. Otherwise, you’ll be fighting a losing and an uphill battle dealing with intensive care teams who don’t necessarily have your best interests at heart.

That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. You can join a growing number of members and clients. We have had hundreds and hundreds of members and clients over the years to improve their lives instantly, while they have a loved one critically ill in intensive care, and making sure they make informed decisions, have peace of mind, control, power, and influence, making sure the loved ones get best care and treatment, always.

When I talk to you and your families directly, if you sign up for my consulting and advocacy, I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly with you or on your behalf or I set you up with the right questions. 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. I also represent you in family meetings with intensive care teams, and you will see the dynamics will change very quickly in your favor when you have someone on your team that understands intensive care inside out.

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.

We also 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, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 e-books and 21 videos that I have personally written and recorded and that will give you help to make informed decisions, have peace of mind, control, power, and influence, making sure your loved ones get best care and treatment always.

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, like, comment, and subscribe to my YouTube channel, share the video with your friends and families.

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’re a subscriber to my email newsletter at intensivecarehotline.com or if you’re 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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