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If you want to know if your critically ill loved one in intensive care on a ventilator with a tracheostomy after ECMO for lung failure should be sedated with propofol, fentanyl, Dilaudid, ketamine, and Valium, stay tuned. I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com and this is another quick tip for families in intensive care.

Currently, we are working with a client who has their 19-year-old son in intensive care. He had lung failure. He’s got a history of asthma, he ended up with lung failure, ended up with ARDS (Acute Respiratory Distress Syndrome) and on ECMO (ecmoextracorporeal-membrane-oxygenation) (for a couple of weeks. He got weaned off ECMO eventually. He ended up with the tracheostomy. He’s now ventilated with the tracheostomy.

One of the first questions that I had for our client was, what stops them from weaning off the ventilator? They said, “Well, he’s on ketamine, fentanyl, propofol, Dilaudid, and Valium.” That is a hell a lot of cocktails for someone with a tracheostomy. One of the main purposes of a tracheostomy is to avoid sedation at all.

I got on the phone with the family and one of the senior nurses there. The senior nurse said that every time they try to wean off sedation, he’s getting agitated and thrashing around. Clearly, this young man is addicted to benzodiazepines like Valium, and he’s also addicted to the opiates like the hydromorph or the Dilaudid and the fentanyl. Of course, as soon as you take that, it’s like taking away the lolly, and then he can’t cope with going through withdrawal.

So why is this important? When you look at the literature, when you look at the research, one of the main purposes of a tracheostomy is simply to eliminate sedation and opiates and then start the weaning process off the ventilator as quickly as possible. Instead of using sedation, the goal should be to mobilize the patient, start physical therapy, start rehabilitation, and not use bucket loads of sedatives and sedation. Get to normalize the patient’s life by getting them out of bed, by starting physical therapy, by sitting them up and so forth. That’s all possible. Any ICU that I worked at, any reputable ICU that I worked at, we would have done that, as quickly as possible, and the outcomes for patients are very, very good.

Now, also, this young man is not hemodynamically unstable. He’s not on any pressors, and he’s not in kidney failure. So, it should be full steam ahead of weaning off sedation and opiates as quickly as possible so he can actually get back to normality as quickly as possible

So, that is my quick tip for today.

I have worked in critical care nursing for 25 years in 3 different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives as part of our consulting and advocacy here at intensivecarehotline.com where you can verify that on our testimonial section, and you can verify it on our intensivecarehotline.com podcast section where we’ve done client interviews.

That’s why we helped hundreds and hundreds of members and clients over the years to improve their lives instantly when they have a loved one critically ill in intensive care. We can do the same for you, and that’s one of the reasons why I 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 hand hold you through this once in a lifetime situation that you simply cannot afford to get wrong when your loved one is critically ill in intensive care. I also talk to doctors and nurses directly, and when I talk to doctors and nurses directly, 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.

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.

We also have an online membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com if you click on the membership link, or if you click or if 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 e-books and 21 videos that I’ve personally written and recorded. That will help you to make, once again, informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment, always.

All of that, you get at intensivecareholine.com. Call us on one of the numbers on the top of our website or simply 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, comment below what you want to see next or what questions and insights you have, and share the videos with your friends and families.

I also do a weekly YouTube live where I answer your questions live on a show. You will get notification for the YouTube live if you are a subscriber to my email newsletter or if you are a subscriber to my YouTube channel.

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: When Is a Tracheostomy Inevitable? Quick Tip for Families in Intensive Care: COVID-19 and ARDS, When is ECMO an Option? Quick Tip for Families in Intensive Care: What Can Happen If You Place a Person on a Ventilator Too Soon or Before it’s Critically Needed? Quick Tip for Families in ICU: Why There Can Be Delays with a Tracheostomy with COVID-19 Patient in ICU? Quick Tip for Families in ICU: Is My Dad Really in Multi Organ Failure in ICU? Can He Survive?