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

So, today I have an email from Roxanne who says,

“Hi Patrik,

My sister was hit by a car 5 days ago when she was on the bike. She was in a coma for that night, in the hospital in ICU. They did a CT scan on her and put her in an induced coma or sedation, not sure. The next day, they transferred her to a metropolitan hospital through great effort and pressure from us.”

Now, I just need to interject there that an induced coma can only happen with sedation or sedatives, just for terminology here. Often this goes hand in hand also with giving opiates such as morphine or fentanyl.

Carrying on from Roxanne’s email.

“There, they put her on high sedation. When I visited her today, I asked her to shake my hand if yes or do nothing if no and I could communicate with her like that. They did another CT scan. She has multiple fractures on the jaw, one leg, fractured sternum, and T6 spine fracture without bone marrow involvement.

Yesterday, they put a leg support on her. They told us to wait every day, so all they did until now is the CT scan and the leg support. I need to ask the right questions, and also, if possible, for you to call the hospital and ask the right questions.

I’m really hoping you can help.”

Thank you so much, Roxanne, for emailing this question.

So, what is really important here is what are the next steps from the hospital point of view. Do they need to operate on her jaw? Do they need to operate on her leg? Do they need to operate on her sternum? Do they need to operate on her T6 spine fracture? Have you asked those questions?

Now, also with the CT scan, I would imagine they would have scanned the brain, especially if they’ve scanned the jaw, they would have scanned the brain as well. Is there any brain hemorrhage? Is there a bleed in the brain? Is there a skull fracture? Is there a traumatic brain injury/TBI? So, you haven’t mentioned any of that and given that your sister can communicate, that is a very good sign. When I say can communicate, she can communicate appropriately by the sounds of things. So, that is a really good sign.

I really believe the way forward here is to find out, do they need to operate on the jaw? Do they need to operate on the leg? I doubt that they need to operate on the fractured sternum. That’s often managed conservatively, same with this T6 spine fracture. Will they just put her in a cast and on bed rest for many weeks and manage the T6 spine conservatively? But that is also a very, very important question. Also, is the T6 fracture potentially a spinal injury? Is the spinal cord damaged as well? That is a very big question.

So, having worked in trauma ICU and I’ve worked in intensive care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. We have saved many lives, and you can verify that on our testimonial section at intensivecarehotline.com. You can also verify it on our podcast section where we have done some client interviews.

So, coming back, jaw fracture probably needs to be surgically treated (operation), same with the leg, most likely. But again, you need to ask, it really depends on the nature of the fracture. Can it be managed conservatively without surgery? Sternum, most likely will be managed conservatively. She might need an epidural or something to manage the pain there. T6 spine fracture, again, is it going to be managed conservatively or with surgery? Has the spinal cord been damaged? That is a very important question.

So, with surgeries pending, there’s a good chance they keep your sister intubated and in an induced coma or lightly sedated until she can have the surgeries. Once the surgeries are done, then there’s a very good chance they will try and wake her up and extubate her. Once again, that’s also assuming there is no brain damage, there is no swelling in the brain, there’s no midline shift. Those are questions you need to find out because it sounds to me like she has been in a massive accident. You need to have those conversations.

It doesn’t sound to me like they have been very transparent with you in terms of what are their next steps because with all these massive injuries, there needs to be a plan, and they need to communicate the plan with you. So, that is my answer to your question.

Also, she will probably need to be on pain medication because she would be in a lot of pain most likely. With a T6 spine fracture, there would also be very limited mobility when they turn her, for example, to change bed sheets, or give her back a wash, check pressure areas and so forth, they would need to move her very, very carefully so that the spine stays straight.

So, I hope that answers your questions. Talk to the doctors, talk to the nurses and get a plan from them now, you have an idea of what to look for and go from there.

Because we get so many questions for families in intensive care here at intensivecarehotline.com, that’s why we created a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, click on the membership link or 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 extensive knowledge and experience working in intensive care for nearly two and a half decades.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I also talk to doctors and nurses directly on your behalf, and 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 when you have a loved one critically ill in intensive care. It is a once in a lifetime situation that you can’t afford getting wrong and I will handhold you through the process making sure you make 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].

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 questions you have or what you want to see next.

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

If you want your video read out and your questions answered fast, because I have so many emails sitting in my inbox from last year even, leave a donation here on the super chat button on YouTube and I will read out your email in a couple of days. You can leave a small donation anyway; it will help us to make as many videos as possible for families of critically ill patients in intensive care and help as many families as possible all over 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.

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