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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can 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 one of our reader’s questions and the questions was
“My husband has severe pneumonia,was ventilated&heavily sedated in the ICU, now he’s confused”
Check it out here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer a question that we get very frequently and therefore I want to answer this question in this week’s “YOUR QUESTIONS ANSWERED” section.
The question that our readers ask is
”HOW LONG IS TOO LONG TO STAY ON A VENTILATOR OR RESPIRATOR?”
Now, if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation on a ventilator/ respirator with a breathing tube(endotracheal tube) and is also in an induced coma, chances are that you and your Family feel challenged, vulnerable, frustrated, out of your comfort zone, out of control, powerless and without influence!
You and your Family also have millions of questions running through your mind and especially with the Intensive Care team being busy and also with the Intensive Care team often not having the willingness to speak your language and to answer ALL of your questions whilst your loved one is critically ill in Intensive Care you may still wonder
”HOW LONG IS TOO LONG TO STAY ON A VENTILATOR OR RESPIRATOR?”
Facts& Figures
Lets quickly look at the facts& figures in Intensive Care. According to most statistics and research that has been published, around 40- 60% out of all admissions to Intensive Care require mechanical and invasive ventilation during their stay in Intensive Care. That’s about half out of all admissions to Intensive Care.
Now, the reality is that if your loved one has been admitted to Intensive Care for critical illness and requires mechanical ventilation with a breathing tube and is in an induced coma- it all depends.
It all depends and it’s very often not “straight forward” or linear
In theory any critically ill Patient in Intensive Care can stay on a ventilator almost indefinitely if they are stable. However I need to break this “indefinite stay” on a ventilator down for you so that you understand the stages.
There are a few scenarios in Intensive Care that generally happen when a critically ill Patient is on a ventilator with a breathing tube and an induced coma. Let’s look at them in detail. You will also find links to other related articles that educate you and your Family about ventilation, induced coma and Tracheostomy in Intensive Care. Just click on the links below the article to find out more!
1) Straight forward “bed& breakfast(b&b)” admission
Your critically ill loved one is a “straight forward” or “soft” admission and only requires the ventilator post surgery and for a few hours up to one day or two. Your loved one won’t need the ventilator/ respirator and breathing tube for very long, will be extubated(taken off the ventilator) and will be out of Intensive Care soon if otherwise stable. Many Intensive Care Units also refer to those Patients as “bed and breakfast” Patients!
2) Not quite “straight forward” but the end of requiring ventilation and the induced coma is in sight
Your critically ill loved one is requiring the ventilator/ respirator, the breathing tube and the induced coma for a few days for a more complex admission such as Pneumonia, Stroke, Sepsis, Head injury, Multi- Trauma, Abdominal Aneurysm Repair etc… You will find a list of most admission scenarios requiring ventilation here.
This situation often means that your critically ill loved one is not a “straight forward” admission however the Intensive Care team has still told you that your critically ill loved one can be taken off the ventilator and “woken up” out of the induced coma within 3-7 days, as a rule of thumb! “Waking up” and getting out of the induced coma can sometimes be challenging and is often not linear or “straight forward”, however chances in this situation to get your loved one off the ventilator within a few days are good! Once off the ventilator your loved one should be able to leave Intensive Care within a few days!
3) A Tracheostomy to wean your loved one off the ventilator is required and the weaning off the ventilator can be achieved within a few days or weeks
Your critically ill loved one requires ventilation for more than 7 days and is still not progressing and the Intensive Care team has hinted that your critically ill loved one will have difficulties to be weaned off the ventilator and therefore the Intensive Care team is thinking about a Tracheostomy insertion. The reason for a Tracheostomy insertion is often that weaning off the ventilator/ respirator can be achieved easier with a Tracheostomy, because your critically ill loved one can be removed from the induced coma that is often a requirement to tolerate a breathing tube. That is often not the case with a Tracheostomy. After a Tracheostomy has been inserted, your critically ill loved one may be removed from the induced coma and can get more alert and might even be able to communicate. A Tracheostomy is just so much easier to tolerate compared to a breathing tube. Furthermore, it is then easier to gradually wean your critically ill loved one off the ventilator/ respirator once the sedation and pain medication has been reduced. Also, your critically ill loved one is then in a situation to be taken off the ventilator for a few hours a day as a starting point and it’s easy to take your loved one off the ventilator and back on again. That gives the Intensive Care team the option to properly assess how your critically ill loved one is progressing towards weaning off the ventilator/ respirator. Once the ventilator/ respirator has been weaned and your critically ill loved one can breathe independently via the Tracheostomy, has a good cough and can swallow, then the removal of the Tracheostomy is the next step. This process can take a few days to a few weeks, depending on your critically ill loved one’s overall situation.
Recommended resources:
Your critically ill loved one has had the Tracheostomy inserted and has come out of the induced coma and has been in Intensive Care for more than two weeks. Sometimes critically ill Patients in Intensive Care who are ventilator dependent and who have a Tracheostomy might be referred to as a “slow respiratory wean” or in other words, your critically ill loved one is ventilator dependent in Intensive Care with a Tracheostomy and there is no end on sight. It’s one of the biggest challenges in Intensive Care and the longer your critically ill loved one is in Intensive Care requiring mechanical ventilation and the Tracheostomy, the challenges such as depression, lack of Quality of life, the risk to acquire an infection in Intensive Care, the lack of natural daylight, the lack of fresh air, a disturbed day and night rhythm, the lack of privacy and dignity and the total lack of control, power and influence are massive challenges for all parties involved. This situation is an extremely difficult situation and thankfully at least in some parts of the world a solution for those Patients to get them out of Intensive Care quicker and in a home care environment exists. For example if you happen to live in Australia INTENSIVE CARE AT HOME (www.INTENSIVECAREATHOME.COM.AU ) is offering a genuine alternative to a long term stay in Intensive Care in a home care environment. Check out their website here www.INTENSIVECAREATHOME.COM.AU
If you don’t happen to live in Australia, your biggest challenge is to have control, power and influence in this situation, because the power dynamics in Intensive Care are often one sided and not equal, with the Intensive Care team having all the perceived power and perceived decision making authority if you don’t challenge it and if you don’t know what’s happening “behind the scenes” in Intensive Care.
Especially in countries where Intensive Home Care services don’t exist the Intensive Care team might suggest to you and your Family that a “withdrawal of treatment” or a “limitation of treatment” might be “in the best interest” of your critically ill loved one.
Your challenge is to look “behind the scenes” in Intensive Care and understand what the Intensive Care team’s interests really are such as research activities, bed scarcity, staffing crisis and the perceived non- financial viability of your critically ill loved one’s (long-term) stay in Intensive Care that could all well impact on how the Intensive Care team positions your critically ill loved one’s prognosis and diagnosis.
Recommended resources:
The bottom line here is that you need to educate yourself quickly and succinctly in order to have control, power and influence, because the Intensive Care team is so used and adept to be “running the show” and have all the power, control and influence whilst your loved one is critically ill in Intensive Care. Your job is to educate yourself quickly how you can have control, power and influence. How can you do that?
I’m glad you’ve asked!
You can leverage your level of power, influence and control whilst your loved one is critically ill in Intensive Care?
You’ll get to that all important feeling of power, control and influence when you download your FREE “INSTANT IMPACT” report NOW by entering your email below! In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to get real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Our FREE reports help you with in-depth insight that you must know whilst your loved one is critically ill or is dying in Intensive Care! Sign up for your FREE membership and download your FREE “INSTANT IMPACT” REPORT now!
In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!
In your FREE report you’ll also discover
- How to ask the doctors and the nurses the right questions
- Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
- How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
- 5 “killer” tips& strategies helping you to get on the right path to PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
- How to stop being intimidated by the Intensive Care team and how you will be seen as equals
- You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
- How you need to manage doctors and nurses in Intensive Care(it’s not what you think)
Thank you for tuning into this week’s episode of “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section for more tips and strategies or send me an email to [email protected] with your questions!
Also check out our Products section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 consulting!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
Sincerely, your Friend
Patrik Hutzel
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