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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, “My mom is in ICU intubated and heavily sedated for over two weeks, and now she won’t wake up.” Now, I know from experience how frustrating this is for families in intensive care when they go through this long waiting process to see their loved ones in an induced coma, and then they’re not waking up.

And it comes back to what I say over and over again 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. This is one of those situations where you don’t know what you don’t know.

So, what do I mean by that? So, you’re saying she’s been sedated for over two weeks and now she won’t wake up. So the question here is, if she is still sedated, then it’ll be very difficult for her to wake up. If they stop sedating her and she’s not waking up, that’s a different story. And one of the questions that I’m asking here is, is your mom, for example, having a brain injury? Or did she have any neurological events such as a stroke, seizures, a hypoxic brain injury, God forbid, a traumatic brain injury? Or is she simply not waking up for unknown reasons?

If she is still sedated, the question is what sedatives is she on? Is she on propofol? Is she on midazolam or Versed? Is she on Precedex? If she’s on any of those medications, is that given in combination with opiates such as fentanyl or morphine? If that is the case, what’s the dosage? Is she getting a hundred milligrams an hour of propofol? Is she getting 10 milligrams an hour of midazolam? Is she getting 5 micrograms an hour of Precedex? Is she getting 50 micrograms an hour fentanyl, or 5 milligrams an hour of morphine? So, the devil is in the detail.

When you have a loved one in intensive care, the devil is absolutely in the detail, which is why we are saying over and over again, you need someone to look at the medical records or you need someone like us to talk to the doctors and nurses directly to find out what is exactly happening. ICU teams are notorious for not even telling you half of what’s going on, and even if they told you what’s going on, they’re not telling you the implications of it.

If your mom is heavily sedated with medications such as midazolam/Versed and morphine, for example, and in combination, maybe her liver function is impaired, maybe her kidney function is impaired. So then, there will be a delay most likely for waking up. And again, if your mom, for example, is heavily sedated and she’s got a brain injury, there could be another delay in waking up.

Now, let’s just take a scenario here where your mom has been off sedation, off opiates for the last three days and she’s not waking up. Her situation has not changed in the last three days, even though they stopped sedating her. So if again, that is the case, have they done a CT (Computed Tomography) scan of the brain? Have they done an EEG (Electroencephalograph) of the brain? Have they done an MRI (Magnetic Resonance Imaging) scan of the brain? Has a neurological consult been made?

Other questions here, is your mother, for example, having seizures? Is she having anti-seizure medication because of that? And if she does, is that potentially also adding on to sedative effects? So, it’s a very good question that you’re asking, but it’s also a very broad question.

Other issues that can add onto this is that, for example, is your mom not breathing against the ventilator? Have they tried to wake her up and she’s breathing against the ventilator, she’s asynchronous. They can’t really put her in a spontaneous breathing mode, and then they need to re-sedate her. There are many scenarios that I’m describing here when you’re saying she’s not waking up. It’s a very general statement, and there could be many things, many reasons why she’s not waking up.

I hope that helps to explain that you need to dig deeper with the doctors here, which we can do for you if you contact us because we can ask the questions for you. And most importantly, we know exactly what questions to ask. We know what questions to ask, and we can also look at medical records. Ideally, we do a combination of both, that is the best-case scenario. So, we can dig down very quickly, very deeply. We can help you make informed decisions. Very important that you can actually make informed decisions, have peace of mind control, power, and influence, because it sounds to me like at the moment you’ve got none of that.

So, that’s my quick tip for today.

If you have a loved one in intensive care, 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].

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 related, 24 hours a day.

Also, if you need a medical record review, you can contact us as well at intensivecarehotline.com. We review medical records in real time when you have your loved one in intensive care. And we also review medical records after intensive care if you need closure, if you have unanswered questions, or if you’re suspecting medical negligence, we can help you with all of that. But we highly recommend to help us help you review medical records in real time.

Subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what do 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’ll talk to you in a few days.

Take care.