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

Yesterday, I did a quick tip, “My mom’s been extubated yesterday in ICU. She’s improving. Why is palliative care getting involved?”  

Now, this is a client we’re working with right now and basically, what happened in the last 24 hours is that I spoke to the intensive care team there. It turned out that the intensive care team was trying to move our client’s mom towards end of life and palliative care without informed consent.

So, what does the informed consent mean? Well, when someone is being moved to palliative care or towards end of life, there needs to be consent from a patient or if a patient is not in a position to make their own decisions, then the decision needs to come from a family member or a guardian. They were not consulted. 

Now, there was also a language barrier because the patient actually didn’t speak English as their first language. So, the family had to translate everything, and it was a very complex situation.

But the bottom line was that the intensive care team did not want to ask for consent from the from the family or from the patient. They just wanted to move the patient towards end of life. Now, there’s a number of issues here.

The first question that I always have in a situation like that is what’s the hurry to kill someone? Where is the urgency? Because they were giving this lady morphine and midazolam for palliative care, for symptom management. Morphine and midazolam have side effects such as sedative effects, such as respiratory depression. When someone has just come off a ventilator and you give them more morphine and midazolam, there’s a very high chance they stop breathing. Now, that could be perceived as euthanasia. 

Then, there was the other issue that the nasogastric tube was removed, and they weren’t giving her any nutrition. Then, all of a sudden, after I started asking what’s happening with nutrition, at least they started her on some dextrose or some glucose, which is not really nutrition, but it’s better than nothing. Also, they did stop the anti-seizure medications and then they said, “Oh, the midazolam will take care of the seizures.” 

Anyway, cutting the long story short, I spoke to the doctors again today in a family meeting and all of a sudden full treatment has been reinstated. It all comes down to asking the right questions.

As I always say, 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.

This is another prime example that if you don’t ask the right questions, you might get walked all over. If you do ask the right questions and you bring in someone that can give you a second opinion and that can advocate and consult for you, the game is changing.

Now, morphine and midazolam are off. Palliative care is out of the picture. This lady has been reinstated for full care and treatment. She will get some nutrition, she will get a nasogastric tube back in until she can swallow, she will have a swallow assessment, she will get mobilized. All the good things that a patient in intensive care should be getting to get best care and treatment.

I’ve worked in critical care for nearly 25 years in three different countries. I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 at intensivecarehotline.com. 

I can say without the slightest hint of exaggeration that we have saved many lives with our consulting and advocacy. You can verify that on our testimonial section at intensivecarehotline.com, have a look there or you go to our podcast at intensivecarehotline.com and you can look up some client interviews we’ve done to vouch for the work that we have done for them.

Because we’re getting so many questions from families in intensive care, that’s why we also created a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com if you click on the membership link or if you 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.

In the membership, you also have exclusive access to 21 e-books, 21 videos that I have personally written and recorded. All of that will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment.

I also do one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. 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. I also represent you in family meetings with intensive care teams. 

We do medical record reviews in real time so that you can get a second opinion in real time. We also offer 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 from this video, share this video with your friends and families.

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

If you want your email read out quickly, make a small donation with the super chat button and I will answer your question in a video here pretty quickly. I’ve got the email sitting in my inbox from last year and I haven’t even gotten to answer them here on a video. You can also leave a donation there if you want to support our work so that we can make as many videos for families in intensive care all around the world.

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: Ventilator Settings and Arterial Blood Gas Results! Quick Tip for Families in ICU: My Loved One’s Not Getting Better and ICU is Adding More Machines and Treatments While on Ventilator! Quick Tip for Families in Intensive Care: My Dad Died in ICU with Sepsis and Pneumonia after Gall Bladder Surgery, Could He Have been Saved? Another intensivecarehotline.com Success Story: How to Keep Your Ventilated Loved One Out of LTAC (Long-Term Acute Care)! Quick Tip for Families in Intensive Care: Is It Normal for a Nasogastric Tube to Block Regularly in Intensive Care?