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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 the situation that we have with a client who has his wife in intensive care with a hemorrhagic stroke. It’s been about a week ago and she’s not waking up. ICU is telling him she needs to have a tracheostomy and a PEG (Percutaneous Endoscopic Gastrostomy) tube and then go to LTAC. The narrative from the ICU is she’s not going to wake up and that will be for a long time, and she may never wake up. That’s pretty much the narrative the ICU has created.
Now, that narrative might be accurate. I don’t know. But it also needs to be challenged because rather than the ICU talking about, she needs to have tracheostomy, she needs to have PEG, and then go to LTAC. Obviously, this is for a client in the U.S. because LTACs are unique to the U.S.
The conversation should be around, “Well, we will try and wake her up. We will try to rehabilitate her, and we will try and avoid the tracheostomy and get her off the ventilator and extubate her.” Very different conversation to have and a much better conversation to have.
Now, with that narrative, it creates the pathway that is the one size fits all pathway for many patients in the U.S. in ICU that supposedly can’t be weaned off the ventilator. I say supposedly. Once again after seven days in ICU, the narrative should be, “We will try and get your mom off the ventilator, and we will do whatever it takes. Then if that fails, then we can start talking about a tracheostomy and a PEG”, because there is still time. The cut off for tracheostomy should be around the 14-day mark. It’s not there yet.
Also, rather than talking about tracheostomy and PEG, the conversation should be had around what about neurological rehabilitation? How can this lady be rehabilitated neurologically after a stroke? Does that involve a tracheostomy and PEG? Maybe, we haven’t looked at the medical records yet, but once we start looking at the medical records, we can actually see what has actually really happened, and is the narrative, this doom and doom narrative, the only narrative that’s applicable here. With that doom and gloom narrative, are we potentially going down a slippery slope of a tracheostomy and PEG whilst not trying to extubate this lady and rehabilitate her neurologically as quickly as possible?
Once again, so far, there has only been one narrative. But then, the lady who was in ICU, her son was also on the phone with me, and he said, “Look, we are realizing that hospitals have their own agendas. We’re slowly realizing that and it’s time to ask questions.”
Once again, maybe the hospital is correct but the only way you’ll find out whether the hospital is correct or not is by, (A), asking the right questions and, (B), by challenging their assumptions. These are once in a lifetime situation that you can’t afford to be getting wrong.
The ICUs goal is to empty their bed as quickly as possible. The narrative that they’ve created so far might be the narrative that the ICU wants to create in order to empty their beds and also not take responsibility to get our client’s wife off the ventilator and avoid the tracheostomy and start talking about neurological rehabilitation. Neurological rehabilitation without a tracheostomy and let alone a PEG tube, will be so much easier, so much easier.
So, 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. They don’t know how to manage doctors and nurses in intensive care.
I have worked in critical 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 all over the world.
You can see what our clients say in our testimonial section and on our podcast section where we’ve done client interviews. I can say with much confidence that we have saved many lives for our clients in ICU by advocating and consulting successfully by knowing what to look for, knowing what questions to ask, and advocating for best care and treatment so we can do the same for you.
That’s also why we created a membership for families of critically ill patients in intensive care. You can become a member when you go to intensivecarehotline.com by clicking on the membership link. In the membership, 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.
In the membership, you also have access to 21 exclusive e-books and 21 exclusive videos that I’ve personally recorded and written, sharing all my decades worth of ICU experience helping you to steer this incredibly difficult environment that is intensive care all 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.
Once again, access to the membership is at intensivecarehotline.com by clicking on the membership link or at intensivecaresupport.org directly.
I also offer 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 making sure that you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment.
I ask all the questions to the doctors and nurses that you haven’t even considered asking but must be asked when you have a loved one in intensive care. The devil is in the detail. I also represent you in family meetings or in meetings with ICU teams with doctors and nurses.
We also offer medical record reviews in intensive care 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].
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.
I also do a weekly YouTube live where I answer your questions live on the show and you can get notification for that if you subscribe to my YouTube channel or if you are a subscriber to our email newsletter at intensivecarehotline.com.
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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