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Quick Tip for Families in Intensive Care: Mom’s on a Ventilator in ICU After PE (Pulmonary Embolus) & 2x Cardiac Arrest. What Treatment is Best for Her? 

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

So, today’s tip is a question answered from one of our readers from Yolanda who says, “I’m not getting the full pictures or answers on how my mom had a PE…” PE stands for Pulmonary Embolus while in ICU and ended up coding two times.” So, coding means she had a cardiac arrest two times. “Now, she’s on a ventilator and I’m uncertain on just how much damage was done and if negligence on the hospital’s part is to blame.” Ok, great question Yolanda. I’m very sorry to hear about your mom having a PE in ICU and now she’s coded two times, which means she had a cardiac arrest two times and she had to be resuscitated two times.

Now, this is a very good question but it’s also typical for families in intensive care because their biggest challenge is 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.

So, let’s break this down, what it means to have a PE (Pulmonary Embolus).

PE stands for a Pulmonary Embolus. A PE often starts as a DVT, a deep vein thrombosis, and then it moves upwards in the body and can cause a pulmonary embolus, which means the thrombus is stuck right in front of the right heart and can cause cardiac arrest. No surprises that your mom ended up being on a ventilator.

Now, in terms of how much damage has been done, it’s difficult to say, of course. If she had a cardiac arrest, maybe her ejection fraction is low now. Maybe her heart has been damaged to the degree where the contractility of the heart is not as good as it was before, i.e., they should be checking for her ejection fraction in an ultrasound or in a transesophageal echocardiogram to find out how much damage has been done.

If she had two cardiac arrests, there’s also the risk that she might have sustain some form of brain damage. Again, they can find that out by either doing an EEG (Electroencephalography), CT (Computed Tomography) of the brain, MRI (Magnetic Resonance Imaging) scan of the brain.

Now, furthermore, you also want to find out what did they do about the PE, did they do a thrombectomy? Did they remove the PE? Did they start breaking down the PE with a thrombolysis? Did they start a heparin infusion which is an anticoagulant or a blood thinner to make sure a DVT developing into a PE is not happening again?

Next, if they can’t use anticoagulation, if they can’t do a thrombolysis or a thrombectomy, have they implanted an IVC filter? An IVC (Inferior Vena Cava) filter is a filter that stops a DVT from moving towards the heart.

Next, is she hemodynamically unstable because a PE or a pulmonary embolus can often cause right ventricular failure or left ventricular dysfunction of the heart, which is probably what has led to the two cardiac arrests.

Next, have they done ABG, an arterial blood gas, to see how effective the mechanical ventilation is right? Also, how hemodynamically unstable is your mom? Did she need to go on an intra aortic balloon pump, for example, or on ECMO (Extracorporeal Membrane Oxygenation)?  Or does she need nitric oxide, for example?

Lastly, is she hemodynamically unstable to the point where she needs inotropes or vasopressors to maintain a physiological blood pressure that’s compatible with life and making sure the damaged heart is pumping.

So, those are some questions that you should be asking.

Now, you’re asking you’re uncertain on how much damage that has been done and if negligence on the hospital’s part is to blame? I wouldn’t know from here. I would love to get on a call with you and with the ICU team and ask some very relevant question or I would love to look at the medical records and find out whether there is negligence or not on whether the hospital is to blame or not.

So, that is my quick tip for today. I hope that helps, Yolanda.

The next step really is for you to call us here at intensivecarehotline.com on one of the numbers on the top of our website or send us an email to [email protected].

Now, we also have a membership for families of critically ill patients in intensive care at intensivecaresupport.org. There, 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. You can also get access to the membership through intensivecarehotline.com and click on the membership link there.

I also offer one-on-one consulting and advocacy over the phone, via Skype, via Zoom, via WhatsApp, whichever medium works best for you. I talk to you and your families directly. I also talk to intensive care teams directly. I ask all the questions you haven’t even considered asking but must be asked so that you can make informed decisions, get peace of mind, control, power, and influence.

Now, we also offer medical record reviews in real time so that you can get a second opinion in real time. So, contact us at intensivecarehotline.com if you want the medical record review in real time, that once again you can make informed decisions, have peace of mind, control, power, and influence. Lastly, 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.

Thank you so much for watching.

If you like my video, subscribe to my YouTube channel for regular updates for families in intensive care, like the video, 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.

Thanks for watching.

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

Take care for now.

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