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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So currently, we are working with a client who just had their mother transferred from LTAC (long-term acute care) back to ICU after she left ICU a few weeks ago. But from our perspective, she shouldn’t have gone in the first place. She should have stayed in ICU because the risk of highly vulnerable patients going back to ICU from LTAC, is just very high. And now, we can see this is exactly what’s happened. Now she’s back in an ICU, so that means she’s in three different facilities within a couple of weeks. That’s just madness. Critically ill patients need a stable team around them to recover and wean them off the ventilator.
Anyway, the purpose of this video today is really that when the client’s mother was going back into ICU, she went back with the chest infection, but also with acute kidney failure, acute kidney injury. And the ICU was saying that she would not be a good candidate for dialysis, that she would probably crash, that her body probably wouldn’t tolerate dialysis, and that she’s at risk of having a heart attack, at risk of having a cardiac arrest. And they were listing all the complications that can occur after or during dialysis. But the purpose of dialysis is really to get the kidneys to recover.
Anyway, what the ICU team didn’t tell our client is obviously that there’s also the option of hemofiltration or CRRT, also known as Continuous Renal Replacement Therapy, instead of dialysis. So, the ICU team was only painting a one-sided picture alluding to the client that dialysis is the only option and that she wouldn’t be a candidate for it.
So, we went back to the client and said, “Look, ask them for hemofiltration”, which is a different form of helping the kidneys to remove fluids and get rid of any toxins. It’s just a slower approach. Dialysis is a sharp, sort of short onset, whereas hemofiltration can go over many days and it means a patient is often on it continuously, which is often what happens in ICU because a smoother approach and a slower approach is often needed because patients are hemodynamically unstable.
And once the client suggests that to the intensive care team, the narrative changed completely. All of a sudden, the client informed himself through us and all of a sudden, the intensive care team gave in and said, “Oh yeah, that could be an option too.” Well, they knew it all the way along, but they weren’t telling our client and the family. And this is what I’m always saying that intensive care teams only tell you half of the story.
If ever, if you don’t ask the right question, you’ll be fighting an uphill battle. And it keeps coming back to what I keep saying over and over again. 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, and they don’t know how to manage doctors and nurses in intensive care. And here is another example that this is exactly the case when it comes to treatment in intensive care.
So, the narrative has now changed to that “their mother would die from kidney failure because it can’t be treated” to “I will put in a dialysis catheter, and will start hemofiltration in the next 24 hours.” That’s a very different narrative now, and it only comes down to, again, sharing all the secrets about intensive care, which is what we do. It’s not a secret, it’s all on our website. It’s no longer a secret, it’s out there. You just need to grab the information and talk to the right people.
So, that is my quick tip for today.
If you have a loved one in intensive care, go to intensivecarehotline.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.
Also, have a look at our membership site for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, and we answer all questions, intensive care and Intensive Care at Home related.
Also, if you need a medical record review for your loved one while they’re in intensive care in real time, we can also do that for you. And if you need a medical record review after intensive care, if you’re suspecting medical negligence or if you’re looking for unanswered questions, we can help you with all of that.
Now, subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next, or what questions and insights you have from this video.
Thanks for watching.
This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.
Take care.