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Quick Tip for Families in ICU: I Can’t See What Drugs My Grandma’s On in ICU, Even Though I Have Access to the Medical Records, Help!

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

So last year, we worked with one of our members who had their grandmother in ICU. And we helped this particular family to keep their grandmother in ICU rather than going to LTAC (Long Term Acute Care) or even worse to a skilled nursing facility prematurely. And in one of my last videos, I showcased how we avoided to having the grandma, having a PEG (Percutaneous Endoscopic Gastrostomy Tube), which is completely unnecessary in this situation.

And today I want to showcase how the intensive care team has been pressuring the family and how we managed to take the pressure off that family. So that you can see what you will get when you are becoming a member for families of critically ill patients at intensivecaresupport.org.

So, a member from last year and I’m not mentioning names here, of course, wrote in, “Thank you. And would there be anything more in specific I could be asking for other than just the official discharge policy? I’ve told the social worker a few times, I want the hospital’s official discharge policy but she seems to be confused because no one has ever asked for that.”

So, what’s happened here is that the hospital was trying to pressure the family to give consent to a PEG tube and then send her to LTAC.  And we told the family not to give consent to a PEG tube because without a PEG tube, patients can’t really leave intensive care, assuming they are ventilated or have a tracheostomy, no LTAC or skilled nursing facility will take them without a PEG tube. They can’t really handle a nasogastric tube because they’re not skilled, that should tell you everything you need to know. Because if they can’t handle a nasogastric tube, how can they handle a ventilator and a tracheostomy, which is more complicated?

So, just by us advising this family to ask the hospital for the discharge policy, which will most likely tell that they can’t discharge a patient to another facility without patient and family consent. Of course, there is one exception to the rule. If someone is well enough to leave a hospital, that’s a different story. You can’t just stay in the hospital if you’re well enough to go home. But that’s certainly not the case with the clients that we are dealing with. They’re very complex. They are very sick. And discharging a patient when they’re very sick is just very unethical and it often doesn’t work in the best interest of a patient.

Now, you can also see here by the response that the client had from the social worker, no one has ever asked for a hospital discharge policy. It’s also a sign that they can just walk all over people without people checking their rights, without people knowing about their rights.

What we’ve also seen is often patients being sent to another state to an LTAC and they’re going hours away from their home, hours away from their families. It just does not make any sense whatsoever. And you need to do your own research from day one. Otherwise, you have no chance in this complex system, that is the hospital system.

And also in this situation, we reviewed medical records online for this particular family as part of their membership.

Now, also, here’s an email from that member who said, “Thank you so much for your help. Earlier, I mentioned my grandmother was saturating 92 to 93% when I stopped by to visit. I just called the nurse to get an update. He said after suctioning her and giving her the breathing treatment, albuterol, she’s now saturating 96 to 97%.

Also, last night, the nurse gave me a list of current medications, what she’s currently on which is Albuterol, Amiodarone, Aspirin, Lovenox, Digoxin and Avastatin. I’m not sure if they’re in the online medical records.

I haven’t seen them on there, so I thought I’d attach them here. And then we found that the list of medications was not in the online medical record.”

So, here’s what’s important for you to know if you do have access to the medical records, which is your right, assuming you are the power of attorney, doesn’t necessarily mean the online medical records are complete.

But again, we can help you with checking that they are complete because we know what needs to be in online medical records or we know what needs to be in medical records, generally speaking.

So, very important that medical records are complete because otherwise there’s almost no point and hospitals are certainly constantly trying to short-change the information they are sharing. And you need to know what to look for.

Unfortunately, you can’t take for face value what’s online. Unless you have a professional like us checking that they are complete, we can very quickly see whether they are complete or not. We have a checklist to go through.

Anyway, let’s quickly comment on the medication that our members’ grandma was on.

Albuterol prevents and treat difficulties breathing, wheezing, shortness of breath, coughing and chest tightness. It’s also known as salbutamol. It’s often used for asthma or COPD (Chronic Obstructive Pulmonary Disease). Also for pulmonary fibrosis.

Next, she is on amiodarone, used to treat irregular heart rhythms such as persistent ventricular fibrillation, but also atrial fibrillation, also known as AFib or AF which this particular lady had.

Next, aspirin, lower the risks of heart attack, clot-related strokes and other blood flow problems in patients who have cardiovascular disease which this particular lady had.

Next Lovenox helps to reduce the risk of a stroke or heart attack. The medications help to keep the blood pressure flowing smoothly by lowering the activity of clotting proteins in the blood. So, it’s also known as an anticoagulant. Lovenox. Anticoagulant is literally a blood thinner.

Next, digoxin used to treat heart failure. It’s often used to improve contractility of the heart.

And atorvastatin used to treat high cholesterol.

Also, when our member wrote in that the saturation of her grandma was dropping and they suctioned her and gave her the other Albuterol that helped. Yes, if it helped. That’s great. And there was probably a sputum plug if the suctioning helped.

But sometimes it can be other things such as, when someone is ventilated, sometimes the PEEP might need to be increased. Sometimes the breathing rate might need to be increased. Sometimes the pressure support or the pressure control might need to be increased depending on what ventilation modes a patient is on. Or sometimes simply FiO2 (fraction of inspired oxygen) has to be increased. This all should be checked by arterial blood gases to look for the effectiveness of mechanical ventilation.

Anyway, I hope that helps for today if you want to become a member and you want to get the same level of intensive care advice when you have a loved one in intensive care, go to intensivecaresupport.org. For our membership for families of critically ill patients there, you have access to me and my team 24 hours a day in a membership area and via email and we answer all questions intensive care related.

I also offer 1:1 consulting and advocacy over the phone via Zoom Skype, WhatsApp, whichever medium works best for you. And I talk to doctors and nurses directly. I can represent you in family meetings, and go through all the questions with you that need to be asked over the phone or Zoom or whichever medium you prefer.

We also offer medical record reviews in real-time. So, if you want a second opinion in real time, please contact us as well. We also offer medical record reviews after intensive care, but we highly recommend you get a medical record review in real time. Medical record reviews after intensive care are really only for if you need closure, if you have unanswered questions or if you’re suspecting medical negligence, but you certainly shouldn’t wait until you have unanswered questions after intensive care you should and you need to answer the questions in real time.

If you have any questions for us, 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 there we can answer the questions that you have about the membership or about the one-on-one consulting.

Now, if you’re finding my videos valuable, subscribe to my YouTube channel  for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next or what questions and insights you have from this video.

Thank you so much for watching.

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

Take care for now.