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YOUR INTENSIVE CARE HOTLINE - Quick Tip for Families in Intensive Care: Who Performs a Tracheostomy? Is it the Best Option? What Questions Should I Ask the ICU Consultant?

/ Patrik Hutzel - Critical Care Nurse Consultant / No Comments

Quick Tip for Families in Intensive Care: Who Performs a Tracheostomy? Is it the Best Option? What Questions Should I Ask the ICU Consultant?

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

So, today’s tip is about an email we had from a reader who writes, “I need to know who performs the tracheostomy. Is this the better choice for my husband? What are the risks? Who performs the tracheostomy? What questions do I need to ask his ICU doctor?” Fantastic question to ask. Let’s dive right into it.

So, in many ICUs nowadays, the ICU consultants may actually perform the tracheostomy at the bedside, and it’s called a percutaneous tracheostomy. They just literally poke a hole in the trachea and insert the tracheostomy. It’s quite a quick procedure nowadays, especially if the ICU consultant is very skilled, takes 30 to 45 minutes. In other instances, a surgeon, an ENT (Ear, Nose, Throat) surgeon, might actually take a patient into the operating room or operating theater to perform a surgical tracheostomy there. Takes longer, requires longer general anesthetic. There’s usually a higher risk when patients go to the operating room or operating theater for a tracheostomy. Could be a short neck, could be anatomy on why patients go into the operating theater or operating room for a tracheostomy rather than having it done at the bedside.

Now, what are the risks? Well, the risks are like, with any surgery, there could be bleeding, there could be surgical emphysema, which I’ve seen for some tracheostomies, where the face blows up because there’s a fistula between the incision side and basically the tissue. Infection risk, of course, the risk is also hypoxia, for example. The risk is the general anesthetic or paralyzing agents often, those are some of the risks. Now, I have written an article and made a video about “What are the risks and benefits of a tracheostomy?” and I will put a link below this video for that article and video.

Now, what questions should you be asking the ICU consultant? The questions that you should be asking are, what are the risks and benefit of a tracheostomy? Where do they see the risks and benefits? But I believe here is the most important question you should be asking the ICU consultant. The most important question you should be asking the ICU consultant is, what have you done or what are you doing beyond the shadow of a doubt to get my husband off the ventilator and the breathing tube and avoid the tracheostomy? That is actually the most important question. I’m not opposed to tracheostomies. What I am suggesting here is, is it the right choice for your husband? That’s the question that I would want the answer to.

So, and again, I have made an article and a video about, “How to wean someone off a breathing tube and a ventilator?” and I’ll link towards that article as well so you can actually see and compare whether they are doing everything beyond the shadow of a doubt to get your husband off the ventilator and the breathing tube.

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] and contact us there.

Now, also have a look at our membership for families in intensive care, intensivecaresupport.org. There, you have access to me and my team in the membership area and via email, and we answer all questions intensive care related, 24 hours a day.

If you need a medical record review for your loved one in intensive care, either while your loved one is in intensive care or after intensive care, especially if you’re concerned that the ICU team is not transparent, if you’re concerned that there’s medical negligence, you should definitely contact us (102). Don’t let any ICU team tell you that you can’t have access to the medical records or that there’s a delay. It’s all a whole lot of nonsense. It’s your right to have access to the medical records. Not a privilege, it’s a right, assuming you are the power of attorney or the next of kin. But again, we can help you with that as well. We never had a client that had access to medical records denied.

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.

Thanks for watching.

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

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