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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 confusion and agitation in ICU after an induced coma. So, one of our readers writes, “My husband has been in an induced coma for about 10 days. He’s now finally extubated and awake, but he’s very confused and agitated. Is this normal and how long will it take?” Well, that’s a great question and unfortunately, this is something that happens frequently in ICU when patients come out after a prolonged induced coma.

The first thing that needs to be ruled out, obviously, if there’s any long-term neurological damage being done, i.e., did he have a stroke? Did he have any seizures that went undetected? Has a CT scan, MRI scan of the brain being done? Does he need an electroencephalograph? Does he need a referral to a neurologist in a situation like that?

Now, other things that are very important and also common sense in a situation like that is just get back to normality as quickly as possible, and that’s easier said than done. He might still be attached to other infusions such as inotropes/vasopressors, you haven’t shared any of that. He might be on other drips such as heparin, who knows what else is going on? So, mobilization might be limited simply because he’s still hooked up to all sorts of infusions and stuff. But it’s important to get good nursing care, regular washes, regular bed baths, mobilization, but also get back to a shower as quickly as possible.

Also, very important, a natural day and night rhythm, i.e., being awake during the day, asleep at night. And that can be very challenging in a busy ICU because there’s often no natural daylight. So, patients might be stuck in a room without natural daylight in ICU and therefore, they completely lose track of day and night. Next, lights in ICU very rarely go out completely. It’s very rarely completely silent. People work 24 hours a day. So, it is very difficult to distinguish whether it’s day or night. That can definitely add on to confusion. Even patient’s sleep gets interrupted during the night because, nurses and doctors are busy doing things like giving medication. If patients are immobile, they need to be turned and washed regularly. So, it is a very busy environment. The sooner someone can leave ICU, the better it is.

What else can you do? You can do things like be around your husband, of course, with other family members, play his favorite music, favorite TV shows, talk to him about things that he does remember.

And often when patients leave ICU, and get back to more normality, that’s when things generally speaking, normalize. Again, that is assuming your husband did not have a stroke or seizures or any other neurological events. So, it is often a side effect of all the things that I mentioned, but also a side effect from all the heavy sedatives and opiates that patients get when they are in an induced coma.

Other things that can happen is he might be going through some form of withdrawal, such as if he was on midazolam or Versed or if he was on morphine or fentanyl, also known as opiates, they are addictive in nature and depending on how much he’s had, he might go through withdrawal. Maybe they need to manage withdrawal.

So, I hope that helps and gives you some ideas of what can be done and how the situation can be improved. Best way is to get out of intensive care to get back to some normality.

So, that is my quick tip for today.

If you have a loved one in intensive care and you need help, go to intensivecarehotline.com. 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 instensivecaresupport.org. There, you have access to me and my team, 24 hours a day, and we in a in a membership area and via email and there we answer all questions, intensive care related.

If you need a medical record review for your loved one in intensive care in real time, we can help you with that and interpret clinical data in real time so you don’t have to scratch your head and wonder what it all means because we can do that in real time for you. We also review medical records after intensive care stays, but it’s so much better if you have them reviewed in real time while your loved one is in intensive care.

Like the video, subscribe to my YouTube channel for regular updates for families in intensive care, I also do weekly YouTube live where I answer your questions on a live stream, share the video with your friends and families, click the notification bell, and comment below whether you agree or disagree, any questions you have, any videos you want to see, share your experience, and thanks for watching.

I’ll see you in another video in a few days.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.

Take care.