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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 again another question answered from one of our members. We actually have a membership for families of critically ill patients in intensive care and you can get your questions answered if you go to intensivecarehotline.com and you click on the membership link or you go to intensivecaresupport.org directly.

So without further ado, let’s get into the question from one of our members that we have actually been working with for quite some time now. This lady has her husband in and out of ICU and let me read out her question.

“Hi Patrik and Team,

My husband is back in ICU. He had a temperature of 105 F and the Physiotherapy and Dispatch Health Team thought it might be an infection from his wounds. So he’s currently on piperacillin and tazobactam and a 5% dextrose injection. Do you think that is accurate or do you think there’s another reason why my husband has an infection?”

Now, for context, this client has gone home with a tracheostomy and nasogastric tube without any help whatsoever. And of course, he would have bounced back into hospital like you’ve heard me say before on my blogs here. No one should go home with the tracheostomy without intensive care nurses 24-hours a day. And case in point, have a look at our sister site intensivecareathome.com there we provide actually Intensive Care at Home where we send intensive care nurses into the home for long-term ventilated and tracheostomy clients.

And when you look at the evidence-based mechanical ventilation guidelines, clearly, they say that you must have 24-hour intensive care nurses at home when it comes to long-term ventilation and tracheostomy. Otherwise, patients bounce back into ICU which is what’s happening here. Or they potentially are even worse or can potentially die. We’ve certainly seen that since we’ve been doing this.

So anyway, let’s answer our member’s question.

I’m very sorry to hear about your husband’s discomfort and present condition. Our team will continue to pray and wish for his healing and fast recovery. Such a high body temperature of 105 °F or 40.5 °C is high and indicates a fever. Good that you immediately brought your husband to the hospital for immediate intervention and treatment. The root cause of his fever must be searched and determined for appropriate treatments. Your husband had been started with IV (intravenous) antibiotics such as piperacillin and tazobactam to immediately combat the causative microorganisms in his body. The doctors must take septic screening tests on his admissions such as MRSA (Methicillin Resistant Staphylococcus Aureus) swabs, respiratory culture and swabs, skin wound, eyes, ears, nose, blood cultures, blood tests for complete blood count, chemistry panel, blood gas, C-reactive protein, ESR, lactic acid, and analysis and culture for urine and stool, chest X-ray, etcetera. But also, they should swab him around his tracheostomy as well as in the nose. All these tests and investigations are very useful in determining the microorganisms present in your husband’s body and in his blood and determining which antibiotic he is resistant to and sensitive to the appropriate antibiotic will be prescribed and administered to your husband after knowing the culture result. Abnormal values in the blood test such as CBC (Complete Blood Count), CRP (C-Reactive Protein), lactate, ESR (Erythrocyte Sedimentation Rate), chest X-ray, et cetera, help determine the diagnosis and severity of his infections. All the test results are helpful in his diagnosis and therapy.

It’s good to hear that they started the tazobactam antibiotic empirically to immediately stop and control the microorganism from multiplying rapidly. Once the blood culture and other tests are released, the doctor or the infectious disease doctor will determine and prescribe the specific antibiotic for his disease, whether the infection is caused by gram-positive cocci or gram-negative or MRSA et cetera. The antibiotics will be reviewed and changed when appropriate and needed or to continue if appropriate to inhibit and kill the causative microorganisms present in the body.

To prevent the continuous rise of your husband’s body temperature, the following measures can also be rendered. Please get a towel and soak it or wet the towel with warm water or cold water. If the fever is too high or his skin is too hot to touch, you can continuously do the sponging or wiping of his face, trunk body, upper and lower limbs, abdomen, thighs, back, axilla, groin, et cetera and place a cold, compress on your husband’s forehead. Avoid the fever from continuously getting high cause a high fever leads to seizures, convulsions, weakness, headache, and many other complications.

When your husband is on tube feeding, you can increase the amount of liquid water to avoid dehydration because he’s sweating. Make sure that your husband is passing a good amount of urine with no urinary retention. Loosening your husband’s tight clothing promotes good aeration and ventilation as well. Suction his airway and free from secretions for good breathing and oxygen saturation as well. Make sure you are preventing infections because of your hand washing, wearing gloves, using hand sanitizers, anti-microbial hand rubs, and wearing masks, et cetera.

Daily wound care is to be done by the nurse aseptically to promote wound healing and avoid severe infections for sepsis. Refer your husband to a surgeon or infectious doctor to assess his wound condition. He also might need to rest and might need simply a good sound sleep and always make sure he feels comfortable at all times. He should still mobilize and do some deep breathing exercises and coughing exercises that would be important for him to continue his recovery. And once again, do not go home without ICU nurses 24 hours a day. It wouldn’t be a good idea. You can find more information at intensivecareathome.com on how we can make that happen for you.

Currently with Intensive Care at Home, we are operating all around Australia, in all major capital cities and regional and remote areas. If you need help in the U.S. or in the U.K., please reach out to us as well. We can point you in the right direction and help you probably privately.

So that is my quick tip for today.

Now, as I said, we have a membership for families of critically ill patients in intensive care.  If you want to become a member and you want to have your questions answered in the membership, go to intensivecarehotline.com. Click on the membership link or simply 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 also offer one one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. And I talk to doctors and nurses directly, I’ll talk to you and your families directly. I’ll make sure that you make informed decisions, and have peace of mind, control, power, and influence when you have a loved one in intensive care. I also ask all the questions to the doctors that you haven’t even considered asking but must be asked so that once again, you make informed decisions, and have peace of mind, control, power, and influence.

Now, I also represent you in family meetings with intensive care teams. As a matter of fact, I’ll make sure to determine whether you should even go into a family meeting with intensive care teams just because they ask you to go to one doesn’t necessarily mean you should be going, but I can give you all the tips and tricks there when we talk one and one.

We also offer medical record reviews in real-time so that you can have a second opinion in real time and you can make informed decisions, have peace of mind, control, power and influence. Furthermore, we also do medical record reviews after intensive care. If you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence, we can do that for you as well.

Now, if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, and click the notification bell. Comment below what you want to see next or what questions and insights you have. Share the video with your friends and families. Go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

Thanks for watching.

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

Take care for now.