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The ICU Team is Giving Me Mixed Messages Why My Mother Should Have a Tracheostomy and PEG (Percutaneous Endoscopic Gastrostomy)! Quick Tip for Families in Intensive Care!

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

Today’s tip is about an email we had from a reader who says, “The intensive care team is not giving me the same reasons why my mom needs a tracheostomy and the PEG.” So, this is one of the frustrations that one of many of our families has that they get conflicting information from different people on the healthcare team or from different people on the intensive care team.

And that is why it’s so important that you get a second opinion from outsiders like we do here on intensivecarehotline.com, where we are a team of intensive care professionals that can give you a second opinion.

Now, let me be clear. When does your loved one need a tracheostomy? Your loved one should need a tracheostomy if they have been on the ventilator for about 10 to 14 days with a breathing tube and it can’t be weaned off the ventilator.

Now, I have done another video and blog posts about “How to wean a critically ill patient off the breathing tube and the ventilator?” Because if you can achieve that, then your loved one won’t need a tracheostomy. So, therefore, the goal always needs to be – to wean a critically ill patient off the ventilator and the breathing tube. That should always be the goal, full stop. That happens sometimes over stages, over many days, wean off sedation, wean off opiates, wean ventilation settings and so forth, right, and wake patients up, mobilize them, do chest physiotherapy, chest physical therapy, breathing exercises, coughing exercises, as much as you can and use minimal sedation and minimal opiates if you can.

So, I’m not sure why intensive care teams would give you conflicting information. The indication for a tracheostomy is usually pretty clear. Other indication that I haven’t mentioned now is for example, neurological conditions such as motor neuron disease, cerebral palsy, spinal injuries, C1, C2 spinal injuries, in particular. So that’s when you need a tracheostomy as well very often. So therefore, there shouldn’t really be any conflicting information.

Other article that are published over the years is “How long can a breathing tube or endotracheal tubes stay in?” and “How long can you be in an induced coma before tracheostomy needs to be done?” So, there’s plenty of information on our website here at intensivecarehotline.com that we link to in this video and the intensive care team really shouldn’t give you any conflicting information.

So that is my quick tip for today.

I hope that explains when to give consent to a tracheostomy, but do not give consent to a PEG tube. I forgot to mention. That you do not give consent to a PEG tube. A nasogastric tube is perfectly fine. A PEG tube really is only necessary for someone that can’t come off the ventilator and the tracheostomy beyond the shadow of a doubt. Most tracheostomies should be done to wean a patient off the ventilator anyway and if a patient should be weaned off the ventilator, then you don’t need a PEG too.

So do not give consent to a PEG (Percutaneous Endoscopic Gastrostomy) or get a second opinion here at intensivecarehotline.com where we also have a membership for families of critically ill patients in intensive care. You can get access to our membership if you go to intensivecarehotline.com, if you click on the membership link on our website or if 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.

I also offer one on one consulting and advocacy over the phone, via Skype, Zoom, WhatsApp whichever medium works best for you. And I talk to doctors and nurses directly. I talk to you and your families directly. I walk you and handhold you through the intensive care experience very gently.

I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over five years. And I’ve been consulting and advocating for families in intensive care for over 10 years here at intensivecarehotline.com.

Now, I also represent you in family meetings with intensive care teams, so that you have a clinical voice on that meeting so that the intensive care team can’t play with you and so that you can make informed decisions, have peace of mind, control, power, and influence.

We also review medical records in real time so that you can have a second opinion in real time. 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.

And all of that, you get once again at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my video, 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, what questions and insights you have from this video, share the video with your friends and families.

Thanks for watching.

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

Take care for now.

Related Articles:

Quick Tip for Families in ICU: Weaning VA-ECMO for Heart Failure, Do you Need Milrinone or Dobutamine? Quick Tip for Families in ICU: Can a Tracheostomy be Done While your Loved One is on ECMO? Quick Tip for Families in ICU: What Questions to Ask When Your Loved One is in Heart Failure in ICU! Quick Tip for Families in ICU: What are Signs that My Mom can be Weaned Off the Ventilator in ICU? Quick Tip for Families in Intensive Care: Why is My Mom Not Waking Up After Two Weeks in an Induced Coma and Paralyzing Agents After Acute Respiratory Distress Syndrome (ARDS)?