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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 has their 78-year-old mom in ICU for a couple of weeks with a bacterial pneumonia. The lady had a trial extubation a few days ago and it failed. Initially, the intensive care team talked about doing a tracheostomy if the trial extubation fails, but now they are sort of stalling a little bit, not talking further about it. So, the client reached out to us and asked, why would that be?

So, when we looked at parameters of the ventilator, for example, we saw that the client is probably very close to getting off the ventilator to begin with, and it would be so much better to have the ventilator removed and not have the tracheostomy. It does make sense to avoid the tracheostomy if you can. There are situations where you can, and there are situations where you can’t.

Simply, this lady is on 10 of PEEP (positive end expiratory pressure) and 12 of pressure support. Her respiratory rate seems stable. Her tidal volume seems stable. We haven’t seen an arterial blood gas yet because some of it will come down to that. We haven’t seen a chest X-ray report either, but the client has said that there’s probably some infiltrates on the X-ray and that might be an obstacle for that. So, those are the challenges there.

But it does make sense to hold off with the tracheostomy maybe for a couple of more days. Do another trial extubation if need be, and if that can be achieved. And then, hopefully the tracheostomy can be avoided. If another trial extubation fails, then definitely a tracheostomy needs to be performed. This lady is coming close now to two weeks being in ICU.

And again, it comes back to that 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 that’s what it comes down to in a situation like that.

So, that’s 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 send us an email to [email protected].

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, where we answer all questions, intensive care related, and Intensive Care at Home related.

Also, if you need a medical record review, please contact us as well. We can help you with medical record reviews while your loved one is in ICU or medical record reviews after ICU as well, especially if you suspect medical negligence.

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 will talk to you in a few days.