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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 a case study and also another testimonial from a client.

So, a lady signed up with us, and her 89-year-old mother presented with COVID-19 pneumonia into the ICU with ongoing respiratory failure, hypoxia, delirium, acute and chronic kidney failure, acute and chronic heart failure with preserved ejection fraction.

Now, initially, she went on high flow nasal cannula, high flow nasal prongs as well as, Bumex, to diurese her, to get the kidneys going. And then she went on to BiPAP (Bilevel Positive Airway Pressure) and she went on to BiPAP for quite a few days. And during those days of BiPAP, they were basically not giving any nutrition to this lady.

And there have been enough studies done that during critical illness in the ICU, nutrition for patients needs to be optimized. You can’t find a critical illness if you’re not getting nutrients or fluids. So the patient’s daughter reached out to us and signed up for some consulting. And then I advised her that, this lady needs some nutrition as soon as possible and she already has a nasogastric tube. I guess the challenge here is that, with BiPAP and the nasogastric tube, you have to be very careful giving nutrients through the nasogastric tube because there’s a real risk for aspiration.

And then when people aspirate while they’re on BiPAP, the risk of them needing intubation, a breathing tube in the mouth, getting attached to a ventilator, and potentially needing induced coma are pretty high. So you have to be very measured in your approach here. But one way forward here is always to give TPN (Total Parenteral Nutrition).

Now, this lady, our client had no idea what TPN was. So I suggested to her, “Well, let’s suggest TPN here”, because the intensive care team said, “Well, she can’t have any nutrition”, but she could also say her mother was getting weaker and weaker whilst the BiPAP was improving her lung situation, her respiratory situation. She was getting weaker as time went on because she had no nutrition.

So like I said, we suggested to her to put the pressure back on the ICU team and say, “Well, this lady needs TPN so she can improve her nutritional status and fight the critical illness”.

And we set her up with questions to ask and all of a sudden things changed. They were starting to be for TPN and what you also need to understand when you advocate for TPN in ICUs, you often get the spiel of, well, there’s a high infection risk and there probably is a higher infection risk because patients need a central line or a PICC (peripherally inserted central catheter) line. But then I’m not going into too much detail here now. But central lines and PICC lines have covered that in other videos. And they have covered that in our section about TPN, but you can’t go without nutrition or fluid intake for days on end whilst fighting a critical illness.

So, and here’s what the client says, she says, “Your involvement changed everything. We went from grim not leaving the ICU, so now to leaving the ICU to progressive care and she’s off the BiPAP and she’s getting nutrition.

I’m also referring you to all my family and friends. It makes a huge difference having an advocate as the administrator. I wanted to have a long conversation after I told the doctors, I had an advocate involved, which they could see by the questions I was asking and then everything changed and she got better. I was told previously that they didn’t see her ever leaving the hospital with a grim prognosis.

“What an amazing difference it makes asking the right questions and knowing what to look for and knowing what questions to ask.”

Like, and I can preach here for another 1000 videos that you need help when you have loved ones in intensive care and that you can’t manage it by yourself. You can’t replace having worked in intensive care for over 20 years in three different countries like I have with, managing a loved one in intensive care. And you’ve never seen a situation like that. It’s a very complex situation, having a loved one in intensive care and without having worked in intensive care for decades, you’ll be fighting an uphill battle.

So, I can preach here for hours on end, but if you don’t take action, you will also fight an uphill battle and your loved one is much more likely to die. I mean, I can say without any exaggeration that we have saved lives with our consulting and advocacy. Many lives as a matter of fact. You can look that up on our testimonial section and then you can also look it up in our podcast section with some client interviews.

So, therefore, we also created the membership for families of critically ill patients where you can get access to. 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. And you can get access to the membership by going to intensivecarehotline.com by clicking on the membership link or you can go to intensivecaresupport.org directly.

Again, 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. You also get access to 21 ebooks and videos in the membership that are not publicly available that answer all questions for families in intensive care.

I also offer one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. And I talk to you and your families directly and I talk to doctors and nurses directly and it’ll make all the difference so that you can make informed decisions, have peace of mind, control, power, and influence because 99% of families in intensive care don’t have it.

Once again, I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over five years. And I’ve been consulting and advocating for families in intensive care since 2013 with life-changing outcomes. Have a look at our testimonial section and then our podcast section with client interviews.

We also offer medical record reviews in real-time. So that you can get a second opinion in real-time. All with the goal of you making informed decisions, have peace of mind, control, power, and influence. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure or if you are simply 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].

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. I also do a weekly YouTube live where you can ask questions on the live show. Click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have.

Thanks 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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