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

Now, in today’s quick tip, I want to answer a question from one of our members. We have a membership for families of critically ill patients in intensive care. You can become a member of when you go to intensivecarehotline.com and you click on the membership link, or 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.

Let’s dive right into the question from one of our members who says, “My mom has received a tracheostomy in ICU. They are now pressuring me to get a PEG tube or a G-tube. They said the feeding tube in her nose, which is also known as a nasogastric tube, will eventually cause erosion and asphyxiation. Is this true and something I should be concerned about? She had the breathing tube since October the 24th.” Now, what a great question to ask and it is a question we get quite frequently.

Now, here’s the thing. This is actually a client who is in the U.S. Here’s the thing, getting a PEG in ICU is very U.S. specific healthcare issue. In other countries such as the U.K. or in Australia or in other European countries, patients in ICU don’t get a PEG tube, most of them anyway.

There are exceptions to the rule. The exceptions are for conditions such as long-term ventilation, spinal injuries, motor neuron disease, cerebral palsy, spinal muscular atrophy, Duchenne syndrome, and so forth. There are exceptions to the rule, but 9 times out of 10 in ICU, patients do not need a PEG tube. So, let me explain.

In the U.S., most patients in ICU that can’t come off a ventilator and need a tracheostomy to help them come off the ventilator, the ICU has the goal to send them to an LTAC. LTAC stands for long-term acute care facility. An ICU will tell you that only LTACs can wean patients off the ventilator and the tracheostomy. Well, nothing could be further from the truth.

We have been consulting and advocating for families in intensive care for the last 10 years all over the world, but most of our clients are actually in the U.S. So, we have a very good understanding of what’s happening in the U.S. healthcare sector. Every time clients go from ICU to LTAC, we have our clients beg them to help them to get back to ICU because it’s so bad. From my experience, LTACs are not even the better version of a nursing home, and it’s my experience.

So, one way to avoid an LTAC is by simply not giving consent to a PEG tube. In other countries, patients in ICU can have a nasogastric tube for up to 6 months if they need it. If they need it for as long as staying in ICU, it doesn’t cause any problems.

Whereas a PEG tube, it’s a surgical procedure, doing a PEG tube. It’s not a surgical procedure doing a nasogastric tube. We just have to insert it, followed up by a chest X ray as long as patients are comfortable with it, as long as patients are not feeling discomfort and trying to put it out, the nasogastric tube is perfectly fine.

Now, interestingly enough, there was a study coming out of the U.S. last year in 2022 that actually confirms what I’ve been saying here on my blog for the last 10 years that the PEG tube is not necessary and that the nasogastric tube is much safer than a PEG tube. I will put the study below this video so you can verify what I’m saying and what I have been saying for the last 10 years.

Doing a PEG is not in the best interest of an ICU patient. It’s in the best interest of the ICU to send patients out to LTACs. But LTACs are not designed for clinical need. They are designed to save money and you can’t save money on a critically ill patient. Going to LTAC to save money, which is negligence from my point of view. It’s madness and it’s not in the patient’s best interest, it’s in the hospital’s best interest and it’s in the LTAC’s best interest.

So, that is my quick tip for today.

I hope that helps you understand. I have made other videos about why not to do a PEG tube. I have made other videos, why not to go to LTAC especially if you are in the U.S. So, you can check them out. Go to our website intensivecarehotline.com, type into our search box, “LTAC or why not to go to LTAC?”, “How to avoid PEG tube?” and you get other videos and particles about the issue as well.

Now, like I said, we have a membership for families of critically ill patients in intensive care where you can get access to by going 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.

I also offer one-on-one consulting for families in intensive care over the phone, via Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families, of course. I help you understand what’s happening in ICU. I help you ask the right questions, but I also talk to doctors and nurses in ICU directly. Once I do that, you will actually see that the dynamics would change in your favor, and the ICU team knows they have nowhere to hide. They know that someone is watching you who can hold them to account.

Now, all of that is really, when I talk to doctors and nurses directly, I ask all the questions that you haven’t even considered asking but must be asked for you to have peace of mind, control, power, and influence and most importantly, make informed decisions.

I also represent you in family meetings with intensive care teams. I will be there over the phone or video call, whichever way you want me to attend a meeting so that you don’t get walked all over in those meetings. I have been in hundreds of them, and I know what’s to come and I can assess with you whether you should even go there or what are the conditions you should be going into a family meeting with intensive care teams. Once again, I ask all the questions that you haven’t even considered asking when you have a loved one in intensive care.

I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse manager for over five years. I have been consulting and advocating for families in intensive care for the last 10 years as part of my intensivecarehotline.com consulting and advocacy services.

Now, we also offer medical record reviews in real time so that you can get a second opinion in real time, and so that you can make informed decisions, have peace of mind, control, power, and influence. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

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, and share the video with your friends and families.

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.