Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So this morning, I was talking to a client, he’s got his 76-year old dad in ICU after pneumonia that developed into ARDS, which is also known as lung failure.
Now, the client has been in intensive care since the 10th of January. At the time of the recording of this video, which is the 3rd of February, he has been ventilated with a breathing tube and his sedation came off about a week ago and he has no signs of waking up. His Glasgow Coma Scale (GCS) varies between a 3 and a 6. He is not opening eyes spontaneously, it’s not there yet, but the intensive care team has done an MRI scan of the brain. They’ve done a CT scan of the brain. They’ve done an EEG and clearly brain function is there.
Now the client is asking, should they give consent to a tracheostomy? And my answer to this is a clear yes, because the brain is intact. And from experience, I can tell you most patients in intensive care, after a prolonged induced coma do wake up especially if they’ve been heavily sedated, which was the case in his dad’s situation.
He is also on kidney failure, he is on dialysis, which means the kidneys take a longer time to excrete any sedatives. So there’s still sedatives and opiates floating around in the body and it often takes longer to get rid of them, which delays the waking up process.
Otherwise, he is fairly stable. He’s not on any inotropes or vasopressors. He’s in a regular heart rhythm, so there’s no other major organs going off besides the brain not functioning at the moment. And besides the kidney’s not functioning.
Obviously he’s still on a ventilator, but he’s now breathing spontaneously. And he’s breathing on CPAP and on pressure support with good blood gases. So, there’s definitely hope that his dad can wake up and if he doesn’t wake up, they could still talk about comfort care.
So that is my quick tip for today.
When to do a tracheostomy, should you give consent? If you think you’re at crossroads, if you have a loved one in intensive care, go to intensivecarehotline.com, call us on one of the numbers on the top of the website, or send us an email to [email protected].
Like this video, comment below what you want to see next, subscribe to my YouTube channel and click the notification bell, and I will talk to you in a few days.
This is Patrik Hutzel from intensivecarehotline.com, all the best to you.