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

So today, I had a very distressed lady on the phone who says her 81-year-old mother has been admitted to intensive care about two weeks ago with respiratory distress, Type 2 respiratory failure because she’s got longstanding asthma. She went into emergency into the emergency department with shortness of breath and fatigue. She also has a history of heart failure, so she ended up in pulmonary edema. Long story short, she ended up being intubated and in intensive care for about 10 or 11 days.

After about 11 days, she went into LTAC (Long Term Acute Care). So, this is obviously a client in the U.S., and she went in into LTAC after about 11 days in ICU. The ICU team told her that the “normal course” in situations like that is a tracheostomy, a PEG (Percutaneous Endoscopic Gastrostomy) tube, and then off to LTAC and that is the specialist in weaning long-term ventilated patients off the ventilator.

Well, I argue 11 days is not long-term ventilated. She didn’t ask the crucial question of have they done everything beyond the shadow of a doubt to get her mother off the ventilator and avoid the tracheostomy? She didn’t ask that crucial question.

That’s why I keep saying 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. That’s exactly what this lady is dealing with.

She believed everything that the intensive care team was telling her without second guessing, without getting a second opinion, without even knowing what to ask, without even knowing what to look for. This is why you need to take full responsibility for getting the best outcomes for your loved ones.

So, in any case, where to from here? The first thing that I mentioned to this lady, if she had contacted me last week, I would have said to her, “Look, do not give consent to a PEG tube.” That would have been number one. I would have found out what are ventilator settings. Does she have a chance to get off the ventilator? Is she in an induced coma unnecessarily? All those questions should have been asked early on.

She had no idea what I was talking about even. I had to really sit down with her and explain things to her in much depth. If she had not given consent to a PEG tube, because there is no need to give consent to a PEG tube, she would have stayed in ICU and ICU is well equipped to wean patients off the ventilator, that’s their skill.

So now, coming back to the original phone call. The lady said that now after 4 days in LTAC, she realizes what a terrible, terrible mistake it was to let her go to LTAC. She’s realizing that the level of care has dropped significantly. She’s now realizing that it is barely the better version of a nursing home.

Funnily enough after 4 days, they are now already telling her that if they can’t get her off the ventilator, she will go to a skilled nursing facility. So, they’re already trying to make excuses for not getting outcomes or results for her mother.

Now, her and her mother are extremely scared that the situation will go from bad to worse and it probably will because most attacks are simply not equipped. They don’t have the skills or the expertise to wean patients off ventilation and tracheostomy.

So, where to from here? I suggested to this lady that we would help her to get her mother back into ICU. But also, we would need to find out what our ventilator settings. How realistic is it for her mother to get off the ventilator? What needs to happen to get her off the ventilator? So, the next step really is for us to talk to doctors and nurses directly there, look at medical records and then make recommendations from them. That’s the best way forward.

I think at last, our client understood how important it is to do research, to take matters in your own hands and not just take everything that intensive care teams are telling you for gospel. You got to keep in mind that most intensive care teams are making decisions that are in the best interest for them, their hospital, and their ICU, i.e., they’re trying to maximize money flow. They’re trying to maximize bed flow, trying to get the best staffing outcomes as well, i.e., where do they use their staff most effectively?

So, by sending patients out to LTAC or sometimes letting them die means they can maximize money flow, bed flow, staff, resources, staff resource management. and so forth. Then, patients end up in very suboptimal or in very negative situations, which is what’s happening here.

You need to take responsibility when you have a loved one in intensive care. Do not rely on intensive care teams without doing research and without getting a second opinion. They will always do what’s in their best interest, not in your loved one’s best interest.

That’s 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] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, 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 and also Intensive Care at Home related.

I also do one-on-one consulting over the phone, via email, via Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to doctors and nurses directly. I ask the questions you haven’t even considered asking. I also have represented many, many families in family meetings with intensive care teams or teams in LTAC and always gotten good outcomes for our clients. Once they know once the intensive care team or LTAC teams know you have someone on your team who understands the ICU just as well as they do or even better, the dynamics will change in your favor.

We also offer medical record reviews in real time. So, if you need a second opinion in real time, please contact us and we can review the medical records in real time. If you need a medical record review after intensive care because you have unanswered questions, you need closure, or you’re simply suspecting medical negligence, please contact us as well.

Now, if you find value watching my videos, subscribe to my YouTube channel channel, 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 from this video.

Thanks for watching.

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

Take care for now.