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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question was
My Daughter is Critically Ill in the ICU & Why a Medical Record Review is Necessary?
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED”, I am here with a live stream today, where I want to answer your questions if you have a loved one in intensive care. And this is one of the most commonly asked questions for families in intensive care and it’s a question that we get all time. And today’s live stream is about the Archie Battersbee Fight for Life After Parents Lose Legal Battle Over Life Support! What Happened?
Archie Battersbee Fight for Life After Parents Lose Legal Battle Over Life Support! What Happened?
Welcome to another, Intensive Care Hotline and Intensive Care At Home livestream.
Thank you so much for joining me tonight and this morning. Again, if you’re in the U.S., it’s evening time for you, Saturday evening. If you’re in Australia, it’s 10:30 AM in the morning, Sydney, Melbourne time, Brisbane time. If you’re in the UK, unfortunately, it’s in the middle of the night.
Today’s topic of the livestream is, “Archie Battersbee’s fight for life after parents lose legal battle over life support. What happened?” Very timely topic. Archie Battersbee passed away Saturday, the 6th of August. If you haven’t heard of Archie Battersbee, Archie Battersbee was a 12-year-old teenager in the UK, who was found unconscious at home by his mother in April this year. He ended up in ICU, unconscious, on life support, from April up until the 6th of August. And he passed away after his parents fought in court for his life support to be continued, but the courts decided to withdraw life support.
Before I break all of this down today, I want to set the scene a little bit. In case you’re wondering, why am I doing this livestream? What makes me qualified to talk about this topic?
So, my name is Patrik Hutzel. I’m a critical care nurse by background. I have worked in intensive care for over 20 years in three different countries. I have worked for over five years as a nurse unit manager in intensive care. I’m also the founder of Intensive Care At Home, a nursing service where we’re providing intensive care nursing at home for long-term ventilated adults and children with tracheostomy, providing home TPN (Total Parenteral Nutrition). We’re providing services for patients on BiPAP (Bilevel Positive Airway Pressure) , CPAP (Continuous positive airway pressure) and otherwise medically complex patients that would be otherwise staying in intensive care long-term.
I’m also the founder of Intensive Care Hotline, a professional consulting and advocacy service for families in intensive care. And we’re professionally consulting and advocating for families in intensive care all over the world.
Now, I want to go through today’s topic. And at the end of the topic, I will answer your questions. Please keep them to today’s topic. And if they’re not on today’s topic, I will answer your questions at the end of it. But if they’re on today’s topic, please type them into the chat pad.
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So, where I want to start with today is I want to read out a newspaper article in a minute about the whole Archie Battersbee situation, but I also need to give some context around the Archie Battersbee situation. So, any of you watching this, if you are in the UK, but even if you’re not in the UK, you might have heard of cases in recent years of Charlie Gard and Alfie Evans, in particular, in the UK. They were cases between 2016 and 2018, very similar to Archie Battersbee, where parents had toddlers in ICU, in the pediatric ICU for months on end. And they wanted, the parents wanted to continue treatment for life-limiting illnesses. And the courts in the UK decided that a withdrawal of life support would be appropriate. And that a withdrawal of life support is “in the best interest” of these kids and that the parents could not decide what’s in the best interest of their children.
And even though both families, Charlie Gard and Alfie Evans were raising money to get their children to other countries… Charlie Gard, I believe, had therapy lined up in the U.S. Alfie Evans had therapy lined up in Italy and in Germany. The courts in the UK decided that those families had no rights to make decision over their children, where to continue treatment, what’s in their best interest. So, the courts basically decided what’s in the best interest of those children. And at that time, we were working with Alfie Evans’ parents. So, we had a lot of insight with what was happening behind the scenes, but I don’t want to talk about that today. I really want to focus on Archie Battersbee.
So, where I want to start with this, I want to start by reading out a newspaper article or an online article to set the scene. I also want to play a video where the mother is being interviewed after the child has passed away. Let me read out the article from the nationalworld.com website.
Archie Battersbee: what happened to 12-year-old-boy? What is online blackout challenge? When treatment ends?
Hollie Dance announced his passing while outside the Royal London Hospital. Archie Battersbee has died in hospital after weeks of legal battles. The 12-year-old boy had been in a coma since he was found unconscious by his mother, Hollie Dance in April and was being kept alive by a combination of medical interventions, including ventilation and drug treatments.
So, we’re talking about April 2022.
Speaking outside the Royal London Hospital in Whitechapel, East London, Ms. Dance said her beautiful little boy died at 12:15 PM on Saturday, the 6th of August 2022. Archie’s parents had fought a long-running legal battle over the withdrawal of treatment and in recent days, made bids to the High Court, Court of Appeal, and European Court of Human Rights to have him transferred to a hospice to die. Announcing her son’s death to the media, Ms. Dance of Southend, Essex said he fought right until the very end. Speaking through tears, she said, “Can I just say, I’m the proudest mom in the world. He was such a beautiful little boy and he fought right until the very end, and I’m so proud to be his mom.”
A last-ditch plea to the European Court of Human Rights to intervene in the case was rejected late on Friday, following a High Court ruling that he must remain at Royal London Hospital in Whitechapel, East London. Archie’s parents had fought a long-running legal battle over the withdrawal of treatment and in recent days, made bids to the High Court, Court of Appeal, and European Court of Human Rights to have him transferred to a hospice to die.
Hollie Dance, his mom and Paul Battersbee, his dad, had turned to the Court of Appeal after the High Court ruled that moving the 12-year-old boy, who is currently in a coma, was not in his best interest. However, they have not been able to proceed with the appeal after it was thrown out by the judge. Judges concluded, “In all respects, Mrs. Justice Theis’ judgment deals comprehensively with each of the points raised on behalf of the parents. We have reached the clear conclusion that each of her decisions was right for the reasons she gave. It follows that the proposed appeal has no prospect of success, and there is no other compelling reason for the Court of Appeal to hear another appeal.”
The 12-year-old has been in a coma since he was found unconscious by his mother in April and is currently being kept alive by a combination of medical interventions, including mechanical ventilation and drug treatment at the Royal London Hospital in Whitechapel, East London. His parents have fought a long-running legal battle over the withdrawal of his treatment, which ultimately failed on Wednesday, the 3rd of August, when the European Court of Human Rights refused to intervene. The judge refused permission to appeal against her ruling after lawyers for the family requested it. Doctors treating the schoolboy for the last four months declared Archie to be brain stem dead, prompting a lengthy but ultimately failed legal battle by his family to continue his life support treatment in the hope he would recover.
On Wednesday, 3rd of August 2022, the European Court of Human Rights refused an application to stop doctors withdrawing Archie’s life support. His mother, Hollie Dance and father, Paul Battersbee, launched an urgent bid to have him transferred to a hospice to die, resulting in another hearing which ran until late on Thursday, 4th of August, into the nighttime. But in a ruling on Friday, the 5th of August morning, Mrs. Justice Theis concluded it was not in Archie’s, and I need to set that in, “best interest” to be moved.
Hollie Dance, the boy’s mother said she wanted her son to spend his last moments together with family privately. The 12-year-old boy has been in a coma since he was found unconscious in April and is being kept alive by a combination of medical interventions, including ventilation and drug treatments at the Royal London Hospital in Whitechapel, East London. Barts Health NHS Trust has said Archie’s condition is too unstable for a transfer and that moving in by ambulance to a different setting “would most likely hasten the premature deterioration the family wishes to avoid even with full intensive care equipment and staff on the journey.” A High Court order made in July requires that Archie remains at the Royal London Hospital while his treatment is withdrawn.
A family spokeswoman said a hospice had agreed to take him. Archie’s parents were granted a Court of Appeal hearing on Monday, 1st of August, after the government asked judges to urgently consider a request from a UN (United Nations) committee to keep treating Archie while it reviews his case. However, three judges refused to postpone the withdrawal of life-sustaining treatment beyond midday on Tuesday and also, refused to grant permission to appeal against their ruling at the Supreme Court.
Speaking to Times Radio on Thursday morning, Ms. Dance said the hospital previously told them they would be able to move Archie to a hospice, but then they just totally went back on their word. Asked what the day was going to be like, she grew tearful and said, “It’s going to be awful today. I woke up absolutely sick to my stomach. Like I just feel this hospital has so much to answer for, and I don’t really know what else to say today.” Supreme Court judges said they have great sympathy with Archie’s parents but added that there is no prospect of any meaningful recovery.
So, just what happened to Archie Battersbee, what did the doctors and his parents say? What did the judges say? Here is everything you need to know.
So, Archie was found unconscious at home by his mother on the 7th of April 2022. The young boy was found with a ligature on his head with his mom believing that he may have been trying to partake in an online challenge called the blackout challenge. Archie has not regained consciousness since the accident and has remained in coma since he was found.
When will Archie’s treatment end? Archie’s treatment actually ended on the 6th of August and he’s passed away since. The hospital had originally planned to withdraw treatment on Monday, the 1st of August, at 2:00 PM. This was paused as the Court of Appeal held a virtual hearing, but it rejected a request to postpone stopping Archie’s treatment and said his life support care would end at midday on Tuesday, the 2nd of August. This was delayed while the family unsuccessfully attempted to get the Supreme Court to hear an appeal.
Barts Health NHS Trust had then been planning to withdraw Archie’s life support on Wednesday, August the 3rd at 11:00 AM, unless the family submitted an application to the European Court of Human Rights, which they did. Treatment was then said to be withdrawn on Thursday, August the 4th, but this was paused as the family began an attempt through the courts to get Archie moved to a hospice. Alistair Chesser, chief medical officer for Barts Health NHS Trust, said their “deepest sympathies remain with Archie’s family”, adding, “We aim to provide the best possible support to everyone at this difficult time.”
What did the family and friends say? Speaking to the PA (Press Association) News Agency before the announcement of the Supreme Court’s decision was made, family friend Ella Carter said, “The family would prefer for Archie to be in a hospice if his treatment were to end.” She said, “If this is Archie’s last couple of days, it needs to be peaceful and it needs to be a calm atmosphere. And it’s the complete opposite, really. We would really like it to be in a hospice. I mean, that’s exactly what they’re designed for. They’re so well-equipped to deal with situations like this. If the trust can work with us and cooperate with us in working towards getting him in a hospice, we would be forever grateful for that.” She added, “Archie’s family are constantly talking to him and telling him what’s been going on with the family and his friends. We’ve got loads of videos of his boxers, giving him inspirational messages. We’re constantly playing that to him.”
What did the judge say? Mrs. Justice Theis concluded it was not in Archie’s best interest to be moved to a hospice. The judge said, “Archie’s best interests must remain at the core of any conclusions reached by this court. When considering the wishes of the family, why those wishes are held, the facilities at the hospice, what Archie is likely to have wanted, the risks involved in a transfer and the increasing fragility of his medical condition, I am satisfied that when looking at the balancing exercise, again, his best interests remain as set out in the ruling of July 15th, 2022, that he should remain at the hospital when treatment is withdrawn. The circumstances outlined by Dr. F of the physical arrangements at the hospital and the arrangement that can be made will ensure that Archie’s “best interest” will remain the focus of the final arrangements to enable him peacefully and privately to die in the embrace of the family he loved.”
The parents in the email from their solicitors on August the 2nd, 2022 confirmed, in principle, their willingness to cooperate in these arrangements. After the case was heard at the Supreme Court, the court’s announcement said, “While there was evidence that Archie was a child with religious beliefs, was very close to his mother and would not have wished to leave her alone, those are only some of the factors which the courts have to consider in their evaluation of where Archie’s best interests lie. It was against that background that Mr. Justice Hayden…”
And I need to inject here, Mr. Justice Hayden is the justice that more or less killed Alfie Evans and Charlie Gard a few years ago. He was the one, more or less, telling the families that it’s “in the best interests” of those children to die and not have them flown overseas for alternative treatment.
“It was against that background that Mr. Justice Hayden held that it would not be lawful to continue life-sustaining treatment.” It’s not lawful to continue life-sustaining treatment. Just that sentence in it of itself is just hideous. It’s not lawful to continue life-sustaining treatment. Well, it’s lawful to kill someone. Is it?
“The Court of Appeal upheld that judgment and this court refused permission further to appeal. Now, the application is for a stay of the order authorizing the withdrawal of life-sustaining treatment to give time for the UN committee to consider Archie’s case as the committee has requested. The panel is satisfied, not only that the Court of Appeal has not erred in the sense mentioned above, but that it made the correct decision.” The judges concluded, “According to the law of England and Wales, Archie’s best interest and welfare are the paramount consideration. The panel reaches this conclusion with a heavy heart and wishes to extend its deep sympathy to Archie’s parents at this very sad time.”
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Next, what did the doctors say? Doctors treating Archie at the Royal London Hospital in Whitechapel, East London said they believed his life support treatment should end. Royal London Hospital’s governing trust, Barts Health NHS Trust, which is providing Archie’s care, had asked the judge to make the decision.
A specialist who cannot be named previously told the judge how tests showed that the lower part of Archie Battersbee’s brain stem was significantly damaged and the upper part was also damaged. He said Archie’s prognosis was very grave and told the judge that the youngster’s chances of recovery were very low. He explained the result of recent brain and spine scans to the judge on Monday, June the 6th, 2022. He said there had been no improvements since earlier scans were taken in mid-April but instead, there were signs of deterioration. He added, “The scans show much more conspicuous and worse damage in areas that are very critical.”
Barrister Fiona Paterson, who is leading Barts Health NHS Trust’s legal team asked the specialist if scans showed that parts of Archie’s brain and spinal cord had died and were decaying. He replied, “Yes.” And he told Mrs. Justice Arbuthnot, “The chance of recovery is very low. I think Archie has sustained severe enough brain damage that a point of return is unlikely.” Mrs. Paterson had earlier told the judge, “The scans, once they are interpreted, paint a picture that may be very hard to bear.”
What have Archie’s parents said? Mrs. Dance told Times Radio on Thursday, the 4th of August, “We can’t even have the chance to be in a room together as a family without nurses.” She added, “There’s absolutely no privacy which is why, again, the courts keep going on about this dignified death. Why aren’t we allowed to take our child to a hospice and spend his last moments, his last days together privately? Why is the hospital obstructing it?” Mrs. Dance said she and Mr. Battersbee were extremely disappointed with the Supreme Court’s decision.
A lawyer representing Archie’s parents told the Court of Appeal on 25th of July 2022 that Archie’s mother Hollie Dance has seen indications that Archie, who is attached to a ventilator, has twice tried to breathe independently in the last few days. Speaking on ITV’s Good Morning Britain previously, Mrs. Dance also said she has been at her son’s bedside throughout his treatment and believes she had seen signs he could recover. She said, “I don’t think I’m just fooling myself. I’m quite honest. Why I do know is, as a mother, my gut feeling tells me my little boy is in there and I will continue to fight for him.”
She said Archie had squeezed her hand in his hospital bed, and it was a sign that gave her hope. She said, “Of course, he’s not jumping up and boxing and shouting out and doing his gymnastics off the bed. I don’t expect that. But the fact that he’s doing these little things like squeezing my hand is progress.” On 11th of July 2022, Mrs. Dance told Mr. Justice Hayden that she was 100% sure Archie would want treatment to continue. “I think we come into this world naturally,” she told the judge. “Let nature take its course.” She added, “If it’s God’s will and Archie wants to give up, then let nature take its course.”
Mrs. Dance said Archie was a natural-born fighter. “If Archie gives up fighting his illness and dies, I can accept that,” she said. “But if we switch off the ventilator knowing that Archie will die, I cannot agree to that.” She said, “That little boy is fighting, in my opinion. He cannot talk. He’s unconscious. I’m his voice. I’m going to fight for him until Archie decides I can stop fighting.”
Archie’s father, Paul Battersbee, who also lives in Southend but is separated from Mrs. Dance, told Mr. Justice Hayden that Archie would not want to leave his mother. “I think he should be left for a bit longer,” he said. “I’m not looking at it through rose-tinted glasses, but it has only been 12 or 13 weeks. And doctors have got it wrong before.” He added, “The most important thing for me is to know he has gone in God’s way.”
What is the timeline of events? An appeal from Archie’s parents came earlier this week after a second High Court judge ruled that doctors can stop treating Archie earlier in July 2022. Doctors treating him have said since May, that continued treatment is not in his “best interests” and should end. I’m putting this in quote, “best interest.” The newspaper here doesn’t. I believe “best interest” always needs to be put in quote, because it’s subjective, not objective.
But his parents from Southend in Essex have always maintained that their son should be given more care. Last month, Archie’s family won an appeal against the ruling that he was brain dead. Mrs. Justice Arbuthnot gave a ruling on 13th of June 2022, which meant that doctors could lawfully stop treating Archie Battersbee against the wishes of his parents. That’s outrageous. But on June 29th, 2022, three appeal judges ruled that evidence relating to what was in Archie’s best interests should be reconsidered by a different High Court judge. Mr. Justice Hayden then became the second High Court judge to rule that Archie’s treatment should end on Friday, 15th of July 2022. Ten days later, three Court of Appeal judges supported the High Court ruling that Archie’s treatment could end.
And I need to point out again that Mr. Justice Hayden is the same justice that gave authority a few years ago to kill those little babies, Charlie Gard and Alfie Evans. So, the same justice is now killing another baby. Outrageous. That’s the newspaper article. I now want to play an interview from Archie’s mom.
There we go.
I received it via an email, the judge’s decision. “At that time, I was bathing Archie, washing his hair. So, I didn’t get a phone call. Yeah. So, I received it via email. We knew today would be the last option. Again, it’s part of the system; isn’t it? We knew we were up against the system, but you know what? I promised to get Archie time and that’s exactly what I’ve done. I’ve got him time. It’s not as much time as I wanted. I pray for a miracle, that Archie will wake up tomorrow and show our justice system and the trust for exactly what it is. It’s absolutely disgusting. And I pray that nobody has to go through this anytime soon.
I think that Archie, what’s happened with Arch, has definitely raised a lot of debate, a lot of discussions. I think people are questioning things now. Now, parents are questioning, “Hang on a minute. Why have we got no rights? Why is this somebody else’s decision? Why has it been taken out of their hands as parents? They’ve not got my child’s best interest. You’re just another case number. They don’t care if it was their children.”
And I do think that a whole class thing has to be raised here. If that was one of the Royals’ grandchildren, we wouldn’t be in this scenario now. They would be getting as long on that ventilator as they want. So, again, it’s a class thing. I know other children that have been flown out of this country and got help that they need for exactly the same injury as Archie. A lot of it does come down to class.”
So, I hope you could hear that, what Archie’s mom had to say.
So, it’s heartbreaking what’s happening here that the court in the UK can basically just rule over parents’ decisions, what they think is in the best interest of their children.
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Now, I need to give more context here. A few years ago, when Alfie Evans was in a similar situation, Alfie Evans at the time was 18 months old, again, with a very rare neurological condition. And he was in Liverpool at Alder Hey Children’s Hospital in ICU, in the pediatric ICU. And he was sort in a similar situation. According to the hospital, he wasn’t waking up. But similar to what Archie’s mom says here, the parents at that time thought that his brain was there, that he was responding to the parents. The doctors and the courts denied that.
Alfie Evans’ parents raised money through privately and also, I believe, through the Catholic church at that time, and to fly him out to Italy, to fly him out to America for experimental treatment. Because at the end of the day, they just thought they had nothing to lose. The UK system didn’t want to treat him. We put together a proposal on the family’s behalf for Intensive Care at Home, to get him home with a tracheostomy. It wasn’t that the family couldn’t accept that Alfie was going to die, but they wanted to prolong his life. And they wanted to prolong his life outside of a hospital because also, what was happening at that time, the family was treated appallingly by the hospital. They couldn’t visit their son all the time. They were trying to lock them out. It was just an appalling situation.
And if you think about it, that courts can now rule over families’ wishes and what they perceive is in the best interest of their children. It’s just appalling. I mean, these are not families that would neglect their children. Not at all. They have fought for their children right until the end, and that’s how it should be. Whereas the courts and the NHS (National Health Service), one could argue, is trying to go into population control mode, for lack of a better term, where they perceive that those kids would be a burden for the healthcare system for years, months, potentially decades. And they see it as a burden, predominantly as a financial burden. And that’s just, again, it’s appalling.
Now, let me put more context around this. Obviously, they’ve won the legal challenge that their child, Archie, was not brain dead. So, clearly, it was acknowledged that Archie Battersbee was not brain dead, which probably at least worked in their favor, that they could at least prolong life support for a little bit longer. Now, let me give you more context around when life support is continued in view of severe brain damage.
Now, there was a case in 2013, almost 10 years ago now, Jahi McMath in California, in the U.S. Jahi McMath was a 13-year-old girl who had a tonsillectomy, removal of the tonsils. And a day or two after the tonsillectomy, she had a massive bleed in her throat and she ended up in cardiac arrest. She was resuscitated and a few days later was declared brain dead. Now, the family objected the diagnosis of brain dead. They could not and they didn’t want to accept that brain dead equals legally dead, because that is what’s happening in many countries. That when someone is declared brain dead, that they’re also legally dead.
Now, the family at the time in California found a loophole and they did transfer their child, Jahi McMath, to New Jersey in the U.S. because in New Jersey, brain dead doesn’t equal legally dead. So, once they’ve flown their child or transferred their child to New Jersey, she had a tracheostomy and then lived there on a ventilator for a few more years. And I believe she passed away in 2017 or 2018, but again, the family had more time with her. And apparently, she showed signs of recovery, which is pretty much what Archie’s mom is saying here, that she has seen signs of Archie squeezing fingers when she was visiting him and so forth.
So, it often takes time for the brain to recover. It may not recover at all. But the reality is, if you don’t give people time to recover, they ultimately won’t recover. And in this situation, Archie, unfortunately, didn’t get the time to recover. Now, so from my perspective, the same that happened with Alfie Evans and Charlie Gard a few years ago now happened with Archie Battersbee. And there may have been other cases that didn’t make it to the media, because I do believe the UK, in particular, is just having this nihilistic outlook on when it comes to treating terminally-ill children. They don’t want to give them the time of the day.
Also, unlike here in Australia, where we now have the NDIS (National Disability Insurance Scheme) scheme where there is funding for community care, that doesn’t seem to exist in the UK. One way for the NHS and the government in the UK to deal with those chronically-ill children is just by killing them. They don’t have to deal with it and it’s not a cost for them. It’s terrible. Every life is worth living. It doesn’t matter what the prognosis or the diagnosis is. Every child or every human has the right to treatment, if that’s what they want.
Now, next. Also, want to talk about the hospice situation. Obviously, in the end, when the courts decided that treatment will be withdrawn, the family had the last wish to move Archie into a hospice, so he could die with dignity. Now, it doesn’t make sense to me that he was so unstable to go into hospice, which is what they’re designed for. Again, maybe he could have gone home with a service like Intensive Care At Home. We have certainly provided palliative care for children at home.
Now, I don’t know all the ins and outs of what was going on with Archie in terms of, he was on life support, was he on inotropes? Was he on vasopressors? I don’t know any of that, but it almost coincides with us here at Intensive Care At Home. Just in the last couple of weeks, we have actually provided palliative care at home for one of our clients who was on a ventilator. And the family couldn’t be grateful enough, so that we were able to provide palliative care and end-of-life care at home instead of in a hospital, in an ICU or in an HDU (High-Dependency Unit), but it was a much nicer opportunity to have family present when the child passed away and so forth.
Whereas this was completely denied in this situation. What a disgrace. What a disgraceful situation overall, and I hope that the courts in the UK get their senses together and start advocating for vulnerable and helpless children and also for vulnerable and helpless parents. How terrible is it done when courts can just make decisions over what’s “in the best interest” of a child. They could have flown children outside of the UK to look for experimental treatment. What do they have to lose? There’s nothing to lose. Is the UK worried that if those children get treatment overseas and they can live longer, that they’re going to be a “burden” for the healthcare system? It’s just terrible.
Traca, I have seen that you’re here. I will come to you. I will wrap this up in a minute and then I will address your questions.
So, this is really an ongoing saga in the UK, what’s happening, especially with this Justice Hayden here. I don’t know how this man sleeps at night by now, having given the orders to kill three innocent children. I don’t know how this man can sleep at night, but that’s something this man needs to think about, not me.
Interesting what Archie’s mom says, that in the UK, she thinks it’s a class thing. She says, “Well, if it was one of the Royals, they would be flown overseas for ongoing treatment and experimental treatment.” Look, I can’t talk about the UK. I mean, I have lived in the UK way back then. I do know the UK very well, and there’s definitely some class thing in the UK going on. And I agree with her statement, that if it was one of the Royals, they would get treatment wherever they think it would be appropriate. And I’m almost going as far as that it’s a population control thing nowadays, where sick children are seen as a burden to society, which is very sad. It’s very sad.
Anyway, so I just want to leave it there to give perspective around it; to let people know that, especially our audience in the UK, that you can do your research early enough when it comes to your children being sick. But it’s the same with adults. We have a lot of clients in the UK that are adults, and it’s the same there. Hospitals are trying to pull out as early as possible. The NHS is a socialist healthcare system. It’s got limited resources and patients can feel it every day from all ages. And it’s terrible. It needs to change, so that patients and families can have better outcome and better treatment.
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So, I think that’s it. I would welcome your comments to the topic. And now, let’s come to our questions.
No compassion for Archie and his family. Absolutely, no compassion for those children in the UK. As I said, unfortunately, this is not the first time this is happening in the UK. This has now happened at least three or four times in the last three or four years. And those are the cases that made it to the media. I actually believe there would be other cases that didn’t make it to the media for whatever reason. But it’s good that at least people are talking about it publicly, so people can raise awareness about it.
So, Traca, if you’re happy, I can call you back and then you can talk here on the show, if you like. I don’t want to call you back if you’re not ready for it, but you can just say, “Yes” or “No” and no big deal either way. Or you can type your questions into the chat pad here. It’s up to you how you want to proceed.
Hospital have no compassion for anyone. It’s all about the money, not the patients. Yeah, absolutely. Look, what you’re saying is correct. By the same token, I have worked in hospitals for over 20 years. There’s a lot of good things happening in a hospital. And there are many good people working in hospitals. There are many good people doing the work that they’re supposed to be doing. The majority of things that are happening in the hospitals are actually good, but I’m dealing mainly with the negatives here. And I’ve seen the good, the bad, and the ugly.
Okay. Traca, I’m going to call you back then. Just give me one second and then we can talk about your questions here.
Traca: Hello?
Patrik: Hi, Traca. It’s Patrik here. Can you hear me okay?
Traca: Yes, I can, Patrik. Thank you for calling me.
Patrik: It’s a pleasure. How can I help you this time?
Traca: Yeah, I was just following up. I didn’t mean to interrupt on your topic for tonight, but I just wanted to touch base that I asked for the hospital discharge paperwork and they refused to give it to me today. They said I have to wait till Monday to get that information. So, I’m going to wait till that. And I just had some questions because they’re-
Patrik: Please.
Traca: … weaning my dad off of his ventilator. And then today was his day two of his CPAP weaning for two hours. The respiratory therapist said that he did good, but his volume was a little low but he tolerated it. What does that mean?
Patrik: Yep. Great, great question. So, when someone is on CPAP, it’s basically a spontaneous ventilation mode. So, what that means is, he has to initiate every single breath. He’s getting minimal support from the ventilator. So, CPAP is the mode before… If they can tolerate CPAP for 24 hours and their volumes are adequate, then you can, generally speaking, take them off the ventilator. If their breathing rate doesn’t get too high, you can take a patient off the ventilator.
Patrik: Now, it sounds to me like his volumes are too low. What does that mean? So, volume should be appropriate to a patient’s weight. Do you know your dad’s weight?
Traca: Yeah, he’s about 200 pounds.
Patrik: Okay. Just give me a second. 200 pounds, I just need to get that in kilos because I’m a kilo person. So, that’s about 90 kilos. Okay, so what that means is it’s about 7 to 10 mls per kilo for the volume. So, let’s keep it simple. 10 times 90 kilos is 900 mils. So, what that means is your dad should roughly be breathing 700 to 900 mls per breath. Now, what the respiratory therapist is probably telling you is that his volumes are maybe 500 or 400. That he’s probably under-ventilated or-
Traca: Yes. Yeah. They took him more. Okay.
Patrik: Right. Or you mentioned he was breathing for two hours?
Traca: Yes. They got him on CPAP (Continuous positive airway pressure) for two hours.
Patrik: Right. So, he probably started out okay. Maybe his volumes were fine in the beginning. And then after a little while, they could see the volumes were going down and his breathing rate was going up. And he was looking exhausted maybe. Did they talk about that? That he was looking exhausted?
Traca: Yeah. He did seem to get more tired and more sleepy.
Patrik: Yep. No surprises. And if he’s getting more sleepy, it’s also a sign that his CO2 is rising. His carbon dioxide might be rising. So, when someone is under-ventilated, one of the things that might happen is that their CO2, their carbon dioxide, is rising. And if their carbon dioxide is rising, they might get sleepy. Have you heard of sleep apnea?
Traca: Yes. He does have that. His setting at home is usually at a 13.
Patrik: Oh, so you are saying he’s got a sleep apnea machine at home?
Traca: Yes, he does.
Patrik: Right. Okay. Right. Okay, so if that’s the case, he’s got a sleep apnea machine at home and you’re saying his setting is on 13?
Traca: Yes.
Patrik: Right. Do you know his settings at the moment?
Traca: I don’t know what they have. I mean, I have it. I screenshotted it. I can send it to you. It just shows like a four breaths per minute and it says 490 ml, 8 PEEPs (Positive End-Expiratory Pressure), 30% O2 (Oxygen), minimal volume 8.3, pressure cmH2O 14, RSB (Rapid Shallow Breathing) 33, and then spontaneous 73%, is what it says.
Patrik: Okay, that’s good information. So, that also is telling me he’s actually not on CPAP. He’s on BiPAP.
Traca: Oh, he’s on BiPAP (Bilevel Positive Airway Pressure).
Patrik: He’s on BiPAP. If you’re telling me his PEEP is 8 and his pressure support is 14, which is what I believe I was hearing, that means he’s on BiPAP, not on CPAP. What that means is it’s probably a little… The PEEP of 8 and the pressure support of 14 is too high to have him taken off for now, especially if his volumes are less than 700. What is the volume? You mentioned ml, 480 ml, 580 ml? What did you say?
Traca: His ml is 490.
Patrik: 490. So, the ml means the tidal volume. That’s the volume he’s breathing. So, if he’s 200 pounds, which is roughly 90 kilos.
Traca: Oh, he’s actually 300. Sorry, 300.
Patrik: 300 pounds.
Traca: Yeah.
Patrik: Hang on. So, if he’s 300 pounds, that’s around 136 kilos. So, that means his volumes need to be above 1,000 ml. Above 1,000 ml. So, he’s probably not breathing half of the volume he needs to breathe.
Traca: Okay. That’s good to know.
Patrik: Is he getting mobilized?
Traca: I was able to get the physical therapy in yesterday after I had to fight them after seven of no PT at all. He was able to sit on the side of the bed for 25 minutes-
Patrik: Great.
Traca: … by himself. And he was able to kick his feet 10 times, like three times different, moving side to side. His core strength is very, very strong for 78 days in the hospital. They were very impressed, but that’s been my thing, is I keep telling them mobilization is the most important thing to get him off the vent. And seven days of no physical therapy is ridiculous.
Patrik: He needs to get out of bed every single day. So, picture this, Traca. Picture this. In order to get off that ventilator, he needs to strengthen his upper body muscles, right? If he doesn’t get out of bed, he won’t be able to strengthen his upper body.
Traca: Okay.
Patrik: Right?
Traca: Yeah. And that’s our problem, is we can’t get physical therapy. They were coming in two to three times a week. And now, all of a sudden, because they want to push us to the LTACH (Long-Term Acute Care Hospital) or the subacute, they’re holding back on his physical therapy and his OT (Occupational Therapy) now. And that’s why I had to push them yesterday and say, “This is ridiculous. There’s no reason for him not to be seven days in bed with no physical therapy.” And they keep saying, “Well, we’re not a physical therapy hospital. That’s why he needs to go to an LTAC.” But that’s still not acceptable.
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Patrik: It’s not acceptable. Here is another important aspect of this. Do you know if they’re still doing arterial blood gases?
Traca: They do it randomly. It’s not as often as it was when he had the mucus plug and when he was in ICU.
Patrik: When you say randomly, how frequently would you say?
Traca: Honestly, I could probably say they haven’t done it for probably a week.
Patrik: Okay. Do you have the latest blood gas result?
Traca: The last one I had, I believe, it was like a 54.
Patrik: That would-
Traca: That was about a week ago.
Patrik: Right. It would be good to know if the 54 was his PCO2 (Partial Pressure of Carbon Dioxide) or his PO2 (Partial Pressure of Oxygen). That would be a big difference.
Traca: Okay. I’m not-
Patrik: If it was his PCO2, it’s too high. If it was the PO2, it’s too low.
Traca: Okay. Yeah. Because I know they looked into it, but they never really followed up on it. It just seems like after they wanted to push him out and I’ve been fighting them, everything, all the balls got dropped, because I’m arguing with them and I’m trying to keep him in the hospital, not moving to an acute or an LTACH and they want to fight me. And I keep saying, “Let’s just get him off the vent, so I can get him home safely and we can go from there.” And they’re just being so persuasive and trying to push me and trying to wear me down.
Patrik: Yeah. Before we go back to the clinical, why can’t they show you the hospital discharge policy? If the hospital discharge policy would support what they’re saying, they would show it to you now.
Traca: And the same thing goes back to when I requested his actual physical medical records back on July 21st or 23rd. I called last week and they said, “No, we haven’t been able to get them done yet because there’s so much information that’s still being processed.” But I did get his X-rays, but I haven’t gotten the physical medical records yet. And so, I’m still waiting on those. So, that’s another red flag that they’re going through things.
Patrik: Big, red flag, Traca. In this day and age, medical records should be a link to a website with a username and a password. Nothing should be prepared in this day and age. It should all be ready online.
Traca: And we’ve been fighting with this, with the patient relations, and with the people that organize all of this. It’s been a problem since day one. We’ve been requesting his records and they continually give us excuses of, “Oh, well, we’re having problems. You can only get this amount of information. I don’t know why you can’t get this.” Because I just spoke with other people in line waiting to get in for visitation and they’ve said, “Oh, no, we can get all the records instantly of the doctors and nurses and everything.” And we have not been able to get any access at all since his medical stay.
Patrik: Makes you wonder. Makes you wonder what is it that they have to hide.
Traca: Exactly.
Patrik: Just remind me, which state are you in? You’re in California.
Traca: Yes, we’re in California.
Patrik: Okay. I will send you after this, after we’re getting off this call, I will send you a link to make sure you’ve got it in black and white, that you have the right to access medical records. It’s not a privilege. It’s a right.
Traca: Yeah, that’s the kind of thing to get them.
Patrik: They know that. They know that. So, what is it that they have to hide? I think-
Traca: A lot.
Patrik: A lot. I think you’re on the right track. Just as we were saying yesterday, Traca, I think you’re on the right track in terms of A, requesting medical records and saying, “I’m not going anywhere before I have full access to the medical records and have someone review them.” B, before you’ve looked at the hospital discharge policy, if they know that the hospital discharge policy is supporting what they want to do, they would have rubbed it under your nose. Excuse my language. They would have rubbed it under your nose. Right? But they haven’t.
Traca: Yes. Yes. Because they know I’m not playing. They know I’m an advocate. I’ve been following all of your information and I’m not backing down. I’m the firm one.
Patrik: Yeah. Oh, good.
Traca: And they know it and they don’t like it.
Patrik: No, of course, of course. And the other thing, I was expecting those roadblocks because I’ve seen it over and over again. The minute you’re asking for what you’re entitled to, all of a sudden, “Oh, things are not available. It takes time. We’ve got to do this. We’ve got to do that.” I would now go to the top, which is the hospital CEO. We’ve just had a client or we are still working with a client since last week, and a different situation but to a degree, somewhat similar issues. And now, that we’ve gone to the hospital CEO, things seem to move.
Patrik: The hospital CEOs can’t really ignore a complaint from a family. The doctors will. The doctors will, but a hospital CEO is ultimately in charge of what’s happening on a day-by-day basis. So, if you feel like you’re finding roadblocks now, I would go to the hospital CEO, if I was you and write to him, or potentially pick up the phone. What’s your feeling since we spoke yesterday? What’s you’re feeling about Monday in terms of them doing what they said they would be doing?
Traca: They called my mom last night at five o’clock and asked her what her decision was as far as our two potential candidates of his LTAC or subacute. And my mom told her that we haven’t had enough time to investigate. And she told him that she’s potentially leaving all of this up to me because I’m the advocate for him. And so, we told him he’s recovering at the hospital until he gets off the ventilator and then he will be coming home to continue the rest of his care. And so, that’s where we left it and I haven’t heard from anybody as of today.
Patrik: Right, okay. Okay. So, look, I think that is hopefully enough information in terms of, he needs to get physical therapy every day. Given that at least he’s starting now with BiPAP a couple of hours a day, that’s a starting point. But it needs to be supported every day by… If he now can sit on the edge of the bed for 25 minutes, okay, maybe 30 minutes tomorrow, maybe 35 minutes the day after. It’s not going to happen in big increments, but it will happen slowly over time.
Traca: Yeah. Yeah. And he was able to stand. Last week, he was trying to stand up on his own with support. And on July 21st, before he had his mucus plug, he actually stood two times with assistance but fully all the way up. And then when we got discharged to the pulmonary floor, everybody dropped the ball on him and just putting him off to the side and doing what they’re doing, saying, “Well, we’re not a rehab. We can’t guarantee he’s going to have physical therapy every day. He might get it two times a week, maybe three times a week.”
Traca: And then it went to one time a week because they’re trying to push me to get to these acute, subacute places and LTAC because they keep saying, “Oh, well, they can provide all of this for you, plus wean him off the ventilator. And there’s no reason we can keep him here because, technically, all he’s on right now is a NG (Nasogastric) tube.
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Traca: But I kept explaining he’s had so many difficult times when they’ve weaned him off the ventilator with the mucus plug and all of the dried secretions in his throat and all of that. That this is a problem that he’s not able to move to a different facility, get exposed to a different facility that’s going to put even more stress on him with the delirium. Let’s just keep him here until we can keep him stable, get him off the vent. Then we can move him home safely and continue on his care. And they do not like that at all.
Patrik: No, they don’t like to be challenged.
Traca: No.
Patrik: They don’t like to be challenged.
Traca: And I’ve asked them numerous times for the charge, the nurse manager, to keep the same nurses on. We’ve had one nurse in particular ask, “Can you please? No, I’ll take him on as my primary patient,” because he knows all of his needs and what’s going on because now, he’s dealing with the stage 3, 4 bed sores because they left him in feces overnight-
Patrik: Oh, my goodness.
Traca: … when they wouldn’t allow us to come in overnight and stay. So, I had to prove my federal and civil rights for my dad. And so, we’re dealing with that on top of it now. And the nurse manager now, ever since I brought that up, she has given us a different nurse every single day now. Just because I asked her to keep continuity of care, she’s doing just the opposite to piss me off.
Patrik: Look, what I will say is this, Traca. Having managed nurses for a long time, either in hospitals or in my own service here with Intensive Care at Home, I can understand why sometimes that continuity and consistency of care is difficult. I can understand that. So, I wouldn’t necessarily take that as them trying to do that deliberately. They may. They may, but nursing staffing is incredibly difficult, especially with shortages at the moment.
Traca: Oh, yeah. I get it.
Patrik: So, I’m not sure about that, if your gut is telling you, that’s what they’re doing, they may well do that. But I can tell you that’s-
Traca: It’s just frustrating because we see the same nurses that we’ve requested to continue my dad’s continuity of care on the same floor at the same time.
Patrik: Right.
Traca: And that’s what’s frustrating because I know this is my payback because I’m pushing against them. So, she’s just going to do whatever she can to piss me off. So, I’ve learned to work. I’m just going to back off. Okay, fine. If that’s the game you want to play, then we’ll play it. But I’m still not going to keep not fighting for him.
Patrik: Yeah, sure. No, no. You should definitely. No, no. You should definitely fight for him. There’s no question about it. Look, I think you’ve got some weapons in your arsenal for now. I very much doubt that they will push you out tomorrow, on Monday. I doubt it.
Traca: Yeah, they can’t.
Patrik: They can’t. But obviously, I’m sure you will be very vigilant about this. Keep asking for things and go to the top.
Traca: Okay.
Patrik: Go to the top.
Traca: That’s what I’m doing. I’m going to go to the top. In fact, that’s what I was starting to do tonight, was write up my rough draft to the CEO and explain my concerns and all the discharge information as far as the risk of him being more able of coming back because of all the problems that you’re creating now. He’s going to end up right back and that’s not what we want. We’re just asking, just let wean him off the ventilator. That’s it and then we can get him safely home.
Patrik: Absolutely.
Traca: With the tracheostomy tube and we can get him home with everything. And we’ve even had the ICU nurse that we had for many days that was his primary. And he even said the best thing he can do is just to go get off that vent and come home and recover. Stay out of those places, and that’s what I’m trying to fight for.
Patrik: 100%.
Traca: Because I know that they’re bad. I mean, the two that they gave us, one refused me to do an in-person tour. And the other place was they had severe cockroaches infestations and all of that and they also refused us to do an in-person tour.
Patrik: That’s terrible.
Traca: So, I’m like those are two red flags.
Patrik: Big time. Big time. If you can’t visit those places, what is it that they have to hide? And they need to stop hiding behind the whole COVID. COVID needs to be managed. It’s not going away anytime soon. It just needs to be managed.
Traca: Exactly, exactly. That’s what their excuse is. And it’s never going to go away.
Patrik: No.
Traca: They’re going to use that as an excuse forever now.
Patrik: Absolutely.
Traca: Because they know they can get away with it. But I so appreciate everything you have done. You’ve given me so much support and strength and determination to just go for it. I’m a fighter like my dad has been. And I mean, I love everything that your website provides and I just… If anybody I ever know that has to deal with this, you’re going to be the first one that I suggest to go look.
Patrik: Thank you. Thank you.
Traca: You’re awesome. You’re awesome. So, okay. Well, I will follow through with my CEO letter and I will let you know how it goes. Okay?
Patrik: Yeah. Okay. Keep us in the loop and I will send you… I will get my assistant to send you some information about The California Medical Records Act. We’ve got that because we have so many clients in California where we just disperse the information there, so you will actually see this is a right, not a privilege.
Traca: Okay. I just have one more question. My dad-
Patrik: Please.
Traca: Since he had that new tracheostomy tube put in and it’s XLT (Extended-Length Disposable Inner Cannula Tracheostomy Tube), he’s always been messing with it. Sometimes, he says that he can’t breathe with it. What can cause that? So, we’ve had a speaking cap put in and stuff. We’ve asked him, “Dad, what happens when you’re grabbing at the vent? Why are you trying to pull it off? Why you say you can’t breathe?” And he just says, “It’s uncomfortable. I can’t breathe.” What would be best?
Patrik: Yeah. Do you know the size? Do you know the size of the tracheostomy tube?
Traca: It’s XLT. That’s all I know.
Patrik: Right. Normally, when I say size, usually the size is anywhere… For an adult, it’s usually anywhere between a 6 and a 10 or 11. Especially with your dad’s weight, he might have a size 9, 10 potentially. But anyway, what could that be caused by? The devil is in the detail. (A) it would be ideal to know what size it is. (B) it would be ideal to know whether he’s got an inner cannula within the tracheostomy. Do you know whether-
Traca: Yeah, he does.
Patrik: He does. Okay.
Traca: Yes, he does.
Patrik: So, the first thing when he can’t breathe, I would say the inner cannula is blocked. That’s the first thing.
Traca: Oh, okay. Yeah, because he does have a lot of secretions and when we do… Because they’ve been giving us training. When we do take out the inner cannula, there is quite a bit of secretions that are in there.
Patrik: Yeah. So, that’s the first thing. Inner cannula is blocked. The next question is, is he constantly on a humidifier. Do you know?
Traca: Yes, he is.
Patrik: Okay, that’s good. That should prevent the blockage to begin with. On top of that, on top of the humidification, he should have some saline nebulizers every four to six hours. That might prevent blockage.
Traca: Yes, they-
Patrik: Okay, great.
Traca: They do IVF (Intravenous Fluid) every, I think, eight hours.
Patrik: Okay, great. That’s good. Last but not least, and again, that keeps coming back to the size of the tracheostomy tube. So, let’s just say he has a size 9 or a size 10. Depending on the anatomy of your dad, if the tube is too long, it might actually block at the tip of the tracheostomy tube by simply leaning towards the tissue. Right?
Traca: Okay. Yeah, and that what’s happening.
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Patrik: Right. So, it could be as simple as that the tube is simply too long for him and it leans against the tissue, whereas the tip of the tube should be free.
Traca: Okay. Yeah, he has a lot of granula around his tracheostomy stoma right now. And they’re getting to, on the 15th, they have to do a new tracheostomy tube change every 30 days. And that’s when we’ve noticed, since they put this extra-long piece one in there, he’s just constantly grabbing it and getting frustrated with it and he keeps wording to us, “I can’t breathe sometimes.” And we have to try to readjust it to make sure it’s completely straightforward and not bent to the side or anything.
Patrik: Yep. Exactly. So, (A) the size may still not be correct. (B) if the size is correct for the diameter, they may just have to cut it at the end a couple of centimeters, if that makes sense.
Traca: Okay. Yeah. Because they keep saying they can’t inflate the cuff anymore because it can damage his esophagus.
Patrik: Trachea? Oh, oh.
Traca: Yeah, his trachea.
Patrik: So, are you saying that the cuff is down?
Traca: No. They have it inflated, but they said they can’t inflate it anymore because it can cause more damage.
Patrik: Yes, agreed with that. Especially if he has granulation. You see the challenge is, if they cut it, let’s just say they cut it by a couple of inches, then the inner cannula would have to be cut as well. It sounds very complicated to me. They need to find the right size. They need to find the right size. And last but not-
Traca: But that’s… Sorry, go ahead.
Patrik: And last but not least, you mentioned earlier, PEEP (Positive End-Expiratory Pressure) is 8, pressure support is 14. In order for him to have time off the ventilator, the PEEP probably needs to go down to 5 and the pressure support probably needs to go down to 8. Whilst-
Traca: Pressure support 8 and what was-
Patrik: Whilst the volumes need to be high and that’s the challenge, but that’s also why he needs to have the PT (Physical Therapy) every day.
Traca: That’s what I keep telling them. He’s got to be moving around. Because they’re just making excuses for us to make exceptions to go out to these other places. “Oh, they can get this every day, go out there. We’re not a rehab facility.” And I’m like, “But he’s still in your facility.”
Patrik: That’s right.
Traca: Oh, it’s so frustrating. Yeah, exactly.
Patrik: But at least now you know what you need.
Traca: I totally appreciate everything you have done. Like I said, I will recommend you to anybody I ever have that has to go through an ICU. I wish I would have followed through on this earlier with you because all of your information and website and advocacy… I’m a fighter.Patrik: 100%.
Traca: I told the other day when the LTAC lady came in and gave us our brochures. And I said, “You’re messing with the wrong person because you just… There’s the door. He’s not going nowhere.” And so, I had to do that for my husband. I lost him seven years ago and I had to fight five years for him. And I think it just prepared me even more for my dad and what he’s going through. But we’re at 78 days and I’m still fighting for him, and he’s still fighting for himself too. So, I am not given up till he does.
Patrik: Yeah, absolutely.
Traca: It’s great to have encouragement and backing up with you. And I will definitely continue following up with you and keep you informed in what we’re doing next.
Patrik: Yeah, absolutely. Okay. Well, thank you so much. Thank you so much for reaching out and sharing everything, and I’ll talk to you very soon.
Traca: Thank you so much, Patrik. And I hope this can help other people too.
Patrik: Yeah. Thank you, Traca. All the best for now.
Traca: You have a-
Patrik: You have a good night.
Traca: All right, you too.
Patrik: Thank you, bye.
Traca: Bye-bye.
Patrik: Bye.
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All right, if there are no other questions I want to wrap this up for today and I will have another YouTube live for next week. Next week’s topic will be, “Living with ventilator and tracheostomy at home, some real-world adult and pediatric case studies.” That will be the livestream next week, same time, Saturday night, 8:30 PM. U.S. 5:30 PM Pacific time, 8:30 PM Eastern time, Saturday, the 20th of August. Sunday morning here in Australia, Sydney, Melbourne time, 10:30 AM. I’m looking forward to talk to you then.
Now, if you have a loved one in intensive care, go to intensivecarehotline.com and call us on one of the numbers on the top of our website, or simply send us an email to [email protected].
If you have a loved one in intensive care that wants to go home, you should contact us at intensivecareathome.com. Check out our website. Call us on one of the numbers on the top of our website. Or again, send us an email to [email protected].
Also, have a look at our membership for families in intensive care at intensivecaresupport.org.
We also provide medical record reviews for families in intensive care or after intensive care. If you have any concerns about medical negligence or any foul play, we can help you finding out whether that has happened or not. I would welcome if you give this video today a thumbs up. If you subscribe to my YouTube channel for regular updates for families in intensive care and Intensive Care at Home, and I would welcome if you share this video with your friends and families and click the notification bell.
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Thanks for watching. Thanks for your support. I look forward to talking to you next week. Look out for the quick tip videos that I will release during the week.
And thanks for watching.
This is Patrik Hutzel from intensivecarehotline.com and from intensivecareathome.com. I’ll talk to you next time.
Take care.
How can you become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?
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