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

So yesterday, I made a video with the title, “Why did the ICU team does not inform me about a tracheostomy and TPN as treatment options for my grandfather?” And in the meantime, I had another phone call with the client and was on a call with the intensive care team or with the intensive care specialist.

So, here is what eventuated. So, the client is in ICU with the colectomy or a bowel resection, a pneumonia and he has not been fed. This gentleman has not been properly fed for the last 11 days and the ICU team is very focused on trying to withdraw treatment, trying to make the family feel guilty about continuing treatment and trying to make the family feel guilty for continuing treatment on their grandfather, which is also, by the way, his wish to continue treatment. He has that he has made that very clear to the family that he wants to have treatment no matter what.

Now, literally, the ICU team has not fed him. They have not given him any nutrition for 11 days. They have not educated the family on the option of a tracheostomy as a treatment option because he’s not waking up yet, but he’s only been out of sedation and opiates for the last three days. So, it’s very early days. But once again, the ICU team is trying to make the family guilty to want their grandfather to live. I’m not sure what’s wrong about that. There is absolutely nothing wrong with that, and it’s just another sign that ICUs are pushing families to free up their beds without really considering that this is their grandfather that they dearly love.

Anyway, let’s go back to more of the clinical stuff.

So, the family has given us access to the medical records and here is what is documented in the medical records in the doctor’s report. It says, “Very poor prognosis, given severe protein calorie malnutrition…” Malnutrition is another word for not getting enough nutrition “…which will compromise wound healing surgeries, and there’s another underlying condition. Patient appears actively dying.” Now, again, we looked at the medical records. The patient is certainly critical. There’s no question about that, but that’s what ICUs do, they treat critical illness. If you’re not feeding someone for 11 days, that certainly doesn’t help with critical illness.

If you look at the research, patients in ICU need to be fed and need to get nutrition as quickly as possible to deal with the critical illness. By withholding nutrition, that it’s probably illegal. Imagine you’re starving someone to death, especially with a critical illness. That is highly, it’s not only unethical and amoral, it’s probably also illegal.

Now, it gets better. So, finally we managed to speak to the doctor directly yesterday with our client and like I said, in my other video yesterday, the ICU team did not educate the family about the tracheostomy, and they did not educate the family about TPN as a treatment option because after a colectomy, after a bowel resection, it can sometimes be difficult to start nasogastric feeds straight away at high volumes because the bowels are not ready to absorb, because of the surgery they’ve undergone. But then, the other option in a situation like that is TPN, stands for Total Parenteral Nutrition also known as IV or Intravenous Nutrition.

So then, when we had the doctor on the phone, we said to him, “Well, what about TPN?” And interestingly enough, he back paddled straight away, and he said, “Well, you are in charge, family can do whatever they like.” And he said, “Well, I’ll get my team to talk to you and we’ll start some TPN.”

So first of all, they did not even educate the family about the option of TPN. It was only through us that they even knew that TPN was an option for nutrition. And all of a sudden, the story change from, “Well, he’s actively dying” to, “Well, we can give TPN and if that’s what you want.”

So again, it comes back to Number 1, ICU teams are not even telling you half of the story unless you know what to look for and unless you know what to ask. It comes down to that families in intensive care 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, and it has all these ingredients in this situation. Families don’t know what to look for and ICUs actually literally document, “Well, we let this patient starve to death and not give him TPN.”

Now, the ICU doctor said, “Well, if we give TPN, there’s a high risk for infection.” Yeah, that probably is because it goes through a central line. Got plenty of patients in ICU that have TPN and whatever you give through the central line or through a PICC line (peripherally inserted central catheter line), there is a risk for infection, but everything comes with a risk. Not giving someone nutrition comes with a risk of dying. Giving someone TPN through a central line, comes with a risk of an infection but it also comes with the benefit of maybe surviving. We don’t know, we have no guarantees. But if you’re not trying, you certainly don’t know whether this man will survive or not.

Again, we are making a big impact here for families in intensive care because we know what to look for. We know what questions to ask. We know what angle to take, and we know what you don’t know. That’s exactly right. We know what you don’t know. We know exactly what to look for to get outcomes for our clients.

So, that is my quick tip for today.

If you are in a similar situation and you have a loved one in intensive care and you don’t know what to do, please call us on one of the numbers on the top of our website at intensivecarehotline.com or simply send us an email to [email protected] with your questions.

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.

Also, if you need a medical record review , which is exactly what we’ve done with this particular client, in real time. We reviewed the medical records in real time, then contact us as well. We can help you with a medical record review in real time so that you can get the second opinion that we gave to this family and helped them out big time. But we also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you’re simply suspecting medical negligence.

Subscribe to my YouTube channel for regular updates for families in intensive care, lick the like button, click the notification bell, comment below what you want to see next, and share the video with your friends and families.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.

Take care.