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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 about a question that I had this morning from a client who says their 77-year-old mom is in ICU. She’s been newly diagnosed with liver cancer, and she had surgery a couple of weeks ago. She has not woken up after surgery, which means she’s now on a ventilator with a breathing tube and the intensive care team is suggesting a tracheostomy if she’s not waking up.

Now, I’ve been saying for the longest here that 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.

So, I said to the client, “What are they saying? Why does she need a tracheostomy?” And she said, well, she doesn’t know. “All they said is the next step here is a tracheostomy.” So, before you give consent to a tracheostomy, if your loved one is in a similar situation, you need to reverse the question. The question here is, how can a tracheostomy be avoided? How can your loved one be weaned off the ventilator and the breathing tube? If someone can be weaned off the ventilator and the breathing tube or is having a tracheostomy, that’s like going east or going west. It’s two completely separate and different directions that one would go.

So best case scenario, breathing tube is being removed and the patient can recover and hopefully get back to normality as quickly as possible. On the other hand, if a patient ends up with a tracheostomy, first off, they need to be liberated from the ventilator. Once they’ve been liberated from the ventilator, they need to be liberated from the tracheostomy. So, two completely different scenarios.

So, then I asked the client does she have access to the medical records for her mom, and she said, “No.” I said, “You need to get access to the medical records as quickly as possible.” I asked, “Is your mom still on sedation or not?” She said she doesn’t know. 

Once again, you as a family asking the right questions in a scenario like that is absolutely critical. It’s make or break, it could be life or death if you’re not asking the right questions. What ventilator settings is her mom on? How likely is it she can get off the ventilator? What does the chest X-ray show? What do arterial blood gases show? What medications is she on? What do blood results show? What does potentially a liver ultrasound show? She’s been diagnosed with liver cancer. What do her liver LFTs show (liver function tests in the bloods)? All these questions need to be answered to paint a full picture for a situation like that.

I hope that helps you understand what questions you need to ask when you have a loved one in a similar situation. Really, if you want to take one thing away from this call, instead of asking for a tracheostomy, ask how a tracheostomy can be avoided and how can your loved one be weaned off the ventilator and the breathing tube.

Once again, having the breathing tube removed is like going west and having a tracheostomy is like going east. It’s two completely different scenarios and you want to choose the scenario where a loved one can ideally be weaned off the ventilator and the breathing tube.

Now, I have worked in critical care for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. We have been consulting and advocating for families in intensive care here at intensivecarehotline.com since 2013. We have been saving many lives as part of our consulting and advocacy. You can verify that at intensivecarehotline.com on our testimonial section or you can watch our intensivecarehotline.com podcast where we’ve done some client interviews who vouch and verify for the work we’ve done.

That’s why we created a membership for families of critically ill patients in intensive care and you can become a member if you go to intensivecarehotline.com if you click on the membership link or 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 eBooks and 21 videos that I have personally written and recorded sharing all my 2.5 decades worth of ICU nursing experience with you.

I also do one-on-one consulting and advocacy over the phone, Zoom Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you can’t afford to get wrong. I also talked to doctors and nurses directly on your behalf or with you. 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, and all of that is with the goal of you making informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment.

We also 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, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

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 a subscriber to our email newsletter at intensivecarehotline.com.

If you want your email to be read out here in a couple of days and your questions answered within a couple of days, leave a donation on the super chat button on YouTube and I will get to your email as quickly as possible. I’ve got emails sitting from last year still and I’m just catching up here. Leave a donation anyway if you want to support the work we are doing so we can help as many families in intensive care as possible.

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 ICU: Weaning VA-ECMO for Heart Failure, Do you Need Milrinone or Dobutamine? Quick Tip for Families in ICU: Can a Tracheostomy be Done While your Loved One is on ECMO? Quick Tip for Families in ICU: What Questions to Ask When Your Loved One is in Heart Failure in ICU! Quick Tip for Families in ICU: What are Signs that My Mom can be Weaned Off the Ventilator in ICU? Quick Tip for Families in Intensive Care: Why is My Mom Not Waking Up After Two Weeks in an Induced Coma and Paralyzing Agents After Acute Respiratory Distress Syndrome (ARDS)?