Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

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

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

“Hi Patrik,

The doctors are just riding my husband off in intensive care because of his previous stroke and bleeding history, which was caused by a hospital anesthesia error which due to lack of therapy has left him immobile requiring 24-hour care. Although he is immobile, I feel that he is immobile due to lack of therapy as opposed to being immobile because his brain is not functioning properly.

After two days in ICU where they ventilated him on arrival because they said he wasn’t breathing on his own, although prior to his ambulance ride, when he vomited again, his pulse oxygen was between 89 to 92%, so I assume more vomit went into his lungs as he has pneumonia, which they are treating.

They are recommending a tracheostomy before knowing if he will be able to breathe on his own once the pneumonia resolves and before the blood from bleed is reabsorbed when they could fully access his body’s abilities to function properly.”

Thank you, Diane, for sharing your husband’s situation. I’m very sorry to hear what your husband is going through.

Now, I could not agree more with you that just before they are putting in a tracheostomy or even recommending a tracheostomy, they absolutely need to assess him properly. What needs to happen here is this, I have done a video and an article “How to wean a critically ill patient off the ventilator and the breathing tube?” I would highly recommend you check out that video and I will put the link below this video in the written version of this blog. In that video, I go through it step by step what needs to happen, how to wake up a patient, how to talk them through extubation, what they need to do and so forth.

Because from what you are sharing with me here, they are not doing any attempts to do that. They’re just talking about a tracheostomy and want to wash their hands clean without doing all the hard yards and all the hard work which is often required to wean someone off the ventilator and the breathing tube. It’s a bit of an art rather than a science, especially when it’s coming to complex patients like the situation your husband has been in.

Also, have they done a CT (Computed Tomography) scan or an MRI (Magnetic Resonance Imaging) scan of the brain to see whether there has been more brain damage done potentially, because that is another determining factor whether your husband can wean off the ventilator or not. But here is another determining factor, let’s just say he can’t wean off the ventilator, he may need a tracheostomy in case he can’t swallow, or he can’t cough, he can’t clear his airway.

So, those are questions you should be asking here, whether he potentially can be weaned off the ventilator, but can he actually swallow and clear his airway i.e. cough? Does he have a gag reflex? That I believe is very important in a situation like that.

Also, how many days has he been ventilated for? You haven’t shared that. What are his ventilator settings like? Maybe he’s already close to extubation, I wouldn’t know without knowing his ventilator settings. What are his arterial blood gases like? What are chest X-rays like? What sedation is he still on? What sedation was he on? Is he on opiates? Opiates, for example morphine and fentanyl, has the side effect of respiratory depression, which means breathing can be impaired with opiates.

So, there’s all these questions that we can help you with, but we would need to look at medical records. I would need to talk to doctors and nurses directly before advising you further.

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, which is exactly what you are dealing with right now.

So, that is my quick tip today.

I have worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care all around the world here at intensivecarehotline.com since 2013. I can confidently say that we have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com. You can also verify by going to our podcast section at intensivecarehotline.com where we’ve done client interviews.

That’s also one of the reasons why we created a membership for families of critically ill patients in intensive care. We have helped hundreds of clients with our consulting and advocacy over the years including in our membership. In our membership at intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org directly. When you become a member, you have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I’ve personally written and recorded that will help you to make informed decisions, have peace of mind, control, power, and influence so that you can influence decision making fast, making sure your loved one gets best care and treatment.

Furthermore, I also talk to doctors and nurses directly. I provide one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly. I represent you in family meetings with intensive care teams. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. 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.

We 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.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have, and share the video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for the YouTube live if you are a subscriber to my YouTube channel or if you are a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

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.

Related Articles:

Quick Tip for Families in Intensive Care: What’s the Quality of Life After Tracheostomy? Quick Tip for Families in Intensive Care: Ignorance is No Longer Bliss in the Information Age When You Have a Loved One in ICU! Quick Tip for Families in ICU: Can My 93-year-old Mother be Extubated After 2 Weeks on a Ventilator in Intensive Care? Testimonial from Lara, Your Advice Helped to Save My Husband’s Life in ICU with COVID Last Year! My Dad is Not Waking Up After Midazolam / Versed Coma, Help! Quick Tip for Families in ICU!