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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
What Are the Parameters to Consider Before Doing a Tracheostomy On My Dad in ICU?
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 10 Things You Must Know About Ventilation & Tracheostomy Weaning in Intensive Care – Live stream!
The 10 Things You Must Know About Ventilation & Tracheostomy Weaning in Intensive Care – Live stream!
Wherever you are, welcome to another intensivecarehotline.com livestream. Today’s topic is about 10 things you must know about ventilation and tracheostomy weaning in intensive care. I will break this down further also to how this applies to different locations or different countries, more to say. I will make a distinction between the U.S., Canada, Australia, and the UK as well, because I know we have different audiences here. Whilst the principle of ventilation and tracheostomy remains the same, it is more about what services are available for you and for your loved one in case it takes longer or it can’t happen. I will break all of that down into this video today, so please stay with me.
So, what makes me qualified to talk about this topic? I am an intensive care nurse by background. I have worked in intensive care for over 20 years in three different countries. Out of those more than 20 years, I have spent over five years as a nurse unit manager in intensive care. For the last almost nine years, I’ve been consulting and advocating for families in intensive care as part of intensivecarehotline.com all over the world. We’re also running a service, Intensive Care at Home, where we are providing services at home, intensive care services at home for long-term ventilated patients, predominantly focused on ventilation and tracheostomy.
I do believe I have decades of experience talking about this topic. I’m very happily sharing all of my insights and experience with you today. If you have any questions while I’m talking, please type them into your chat pad and I will get to them. Please make them relevant to the topic if you can. But if they’re not relevant to the topic and you have questions about intensive care specifically, I can get to those questions towards the end of the topic. So, let’s dive right into the, “10 things that you must know about ventilation and tracheostomy weaning in intensive care.”
So, number one, the first thing is that it’s possible. Okay. So if you’ve done any research about intensive care and if you’ve read any of my blogs, don’t be discouraged by the doom and gloom of the intensive care team. Ventilation weaning and tracheostomy weaning is possible. It sometimes takes time. Sometimes it can happen within a few days. Sometimes it can happen within a few weeks. Sometimes it can happen after many months, but it is possible. You need to have the right approach, the right team, the right ingredients, and the right can-do mindset to make it happen. So don’t be discouraged. It’s often two steps forward, one step back. The best advice that I can give you around this is that, you should avoid a tracheostomy in the first place, but I’ve made another video about that, how to avoid a tracheostomy if you have a loved one in intensive care.
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Today, the topic is about for someone that definitely needs a tracheostomy and ventilation. Also, when I say it’s possible… Also, don’t be discouraged by the doom and gloom and the negativity from the intensive care team when they’re telling you, “Oh, your loved one is going to die. They won’t survive. And if they do survive, they won’t have any quality of life,” and all the doom and gloom that you’ve heard all over again. Don’t be discouraged by that. I keep repeating myself here, but more than 90% of patients in intensive care actually survive. Now, I’m not talking about the quality of life here. I’m talking about patients coming into intensive care, being treated for their critical illness, and leaving intensive care alive. So the odds are in your loved one’s favor. Keep that in mind at all times.
Number two, the next thing you need to know is that, ventilation and tracheostomy weaning can only really happen with mobilization. What do I mean by that? It needs to happen with mobilization. It needs to happen by getting out of bed, breathing exercises, sitting in a chair, sitting upright, sitting on the edge of the bed, and marching on the spot. It can’t happen without that. It just can’t. I just haven’t seen it happening without being mobilized. When I talk to families in intensive care all over the world, one of the first questions that I ask them is, especially when they have a loved one in that particular situation, one of the first questions that I’m asking them is, “Is your loved one getting mobilized?” And most of the time, the answer that I hear is no. They also often say, “Oh, they can’t be mobilized.” Well, that’s not true. That’s not true.
In a good intensive care unit, people will get mobilized very, very quickly, very early on. The sooner they get mobilized, the higher chances that people can come off ventilation. Picture this, you can’t run a marathon, if you’re not training. Okay. It’s a very good metaphor for and a very good reference for comparing it to weaning off the ventilator. You can’t wean off the ventilator without training, and mobilization is training. How do you want to strengthen your breathing muscles without mobilizing? It’s just not happening. It’s just not happening. So, mobilization is an absolute must.
Imagine you’ve got a long-term patient in intensive care. They’re getting bed baths. They’re getting nursing care. But one of the best tips that I can give you is, again, in some intensive care that I’ve worked in, they were very good and you take patients to a shower. You give them a bath. You take them to a shower trolley. You put them in the bathroom. You give them a shower. That’s better than any medication you can give. It gives them a sense of normality. It makes them tired. They go back into a day and night rhythm. They go back to some sense of normality. What I’ve heard over the years from patients is if you give them a shower, they say, “Thank you so much. Best thing that I’ve had in the last few weeks.” Little things like that will make a hell of a difference, hell of a difference. It makes them feel human again. Think about that. Think about that.
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Next, number three, it can’t happen without physical therapy or physiotherapy. Okay. That starts with breathing exercises. That starts even before someone had a tracheostomy. It needs to start when people are on the ventilator with a breathing tube. It needs to continue when people have a tracheostomy. A good physical therapist, or respiratory therapist, if you’re in America, will do the breathing exercises with you, will guide you, will change the ventilator setting so that your loved one needs to take more spontaneous breaths, will take deeper breaths. It all goes hand in hand with ventilation weaning. It also goes hand in hand with moving arms, moving legs, and getting out of bed.
A good physiotherapist will instigate mobilization together with a nurse. It’s a team approach, but nothing’s happening without physical therapy. Currently, we’re talking to a client in Los Angeles and he’s got their loved one in ICU for about six weeks now. The ICU is doing very minimal physical therapy. Of course, they’re struggling getting them off the ventilator. It’s a joke. It’s a joke. People need to get started on physical therapy, physiotherapy, and mobilization as quickly as possible. Sometimes there are delays because people have fractures after car accidents or after other traumatic accidents, but if that’s not the case, mobilization is key, absolute key. I can’t stress this enough. I might actually make a whole video just about mobilization in intensive care and the importance of it.
Number four, I already alluded to that, but I need to make it a separate issue, breathing exercises. Okay. So patients often start out in a controlled mode, like in a synchronized intermittent mandatory ventilation (SIMV) mode or in a pressure control mode, or in a volume control mode. And then, hopefully, as time goes on, the support from the ventilator is reduced. And then more and more, they’re moving into what’s called the CPAP or pressure support ventilation mode if your loved one needs to do more and more breathing by themselves. And then, hopefully, they can go on the tracheostomy mask, but that’s not going to happen without someone guiding them and that’s often a good physical therapist, a good physiotherapist, or again, if you’re in the United States and Canada, a good respiratory therapist will help you with that, but also a properly trained intensive care nurse will do it too. Okay. Again, it’s a team effort, but it needs to happen from day one.
If you’re weak and after an induced coma you are weak, someone needs to guide you to take deep breaths, breathe in and breathe out. Someone needs to show you that because your brain might be foggy. Someone really needs to hold you by the hand and walk you and talk you through that, through those breathing exercises. And then, also, when your loved one goes on a tracheostomy mask or a tracheostomy hood, again, that needs to continue, breathing slowly, taking deep breaths, exhaling slowly. It’s an ongoing process until you and your loved one feel confident that they can manage the process themselves.
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Number five, I want to talk about timeframes. I briefly mentioned it in the beginning that timeframes can vary greatly. Okay. Sometimes you do a tracheostomy on a patient. They get out of the induced coma often and they get off the ventilator within 24 or 48 hours and within 72 hours, they’re off the ventilator completely. They may still need the tracheostomy for a few more weeks, but then the tracheostomy comes out, and then the tracheostomy is a blast of the past. A good and a high proportion of patients in intensive care, however, it takes time to wean them off the ventilators. So, one of the reasons you do a tracheostomy is, patients need a prolonged induced coma.
When they have the tracheostomy, yes, sedation can be stopped, but patients, unfortunately, are deconditioned. They have numerous diseases. They are critically ill. So it’s not a quick and easy process. They often have a disturbed day and night rhythm. If they come out of the induced coma, they’re often confused, and agitated. They don’t know what’s happened. They can’t talk. You can imagine the stress that they’re experiencing. And then, somebody is telling them, doctors, nurses, families, “You’ve got a tracheostomy. It will take time to come off the ventilator,” and so forth. Patients are in distress. Therefore, on top of their critical illness, they can often get depressed and it often takes time to get off the ventilator and the tracheostomy.
One of my big pet peeves is, there is no quality of life in intensive care, which is why I’m advocating for a service like Intensive Care At Home, rather than staying in intensive care for ventilation weaning, but I’ll have that as a separate point that I talk about later. But the bottom line is this, it can take weeks, days, sometimes many months. I have seen ventilation and tracheostomy weaning in intensive care for up to 18 months. I’ve heard about up to two years in other places. So, it’s very difficult to ascertain how long it takes. What often happens in intensive care, again, depending on how much research you’ve done, you would’ve seen in some of my other blogs or videos, it’s often two steps forward, one step back.
Currently, we’re dealing with a client. They had a tracheostomy. Within a few days, they were off the ventilator. They were doing incredibly well. And then after three or four days off the ventilator, they ended up with another chest infection and pneumonia, and they ended up with a pleural effusion. So they ended up back on the ventilator, treating the infection, having a chest drain put in, and now they’re getting not stronger again. So they’re still on the ventilator after about 10 days of that happening. So it’s very hard to predict. We’re very positive the client will turn the corner eventually, but it takes time and people have to be very, very patient, unfortunately.
Also, with timeframes, again, it leads me to Intensive Care At Home. Tracheostomy and ventilation weaning can be done at home as well, especially with our service Intensive Care At Home. It can be done at home. A much nicer environment, but you need the right team, but we can help you with setting up the right team for Intensive Care At Home, rather than having weaning off ventilation and tracheostomy in intensive care, where there’s no quality of life and where doctors and nurses don’t really respect your wishes and respect what you want for your loved one, respect the routine that you want for your loved one that you think is best for them.
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Next, and that’s number six, what is important in the weaning process very often is, that your loved one has a tracheostomy with an inner cannula. Okay. Why is this important? Some tracheostomies don’t have an inner cannula. So the inner cannula is a cannula within the tracheostomy that you need to change at least three, four, sometimes five, maybe even six times a day. It gives you a very good indication of, is the tracheostomy blocking? Are there many secretions? If there are many secretions, if the tracheostomy is blocking, it’s probably a sign that your loved one is not quite ready for weaning off the ventilator or having the tracheostomy removed in particular.
And it is a necessary evil, often when you change the inner cannula, it makes people irritated and makes people cough, but it is a very good indicator of how quickly your loved one can be weaned off the ventilator or have the tracheostomy removed. If they can cough up their secretions, that’s a very good sign that they can protect their airway. If their cough is very strong, those are all very good signs. Also, in the sequence of events, the ventilator needs to come off first before you can even look at removing the tracheostomy. One can’t really happen without the other. So have a look at whether your loved one has an inner cannula with their tracheostomy. Often, what also happens, and that leads me to my next point, is that nebulizers should be given, especially normal saline nebulizers, just to keep the lungs moist.
So picture this, when you breathe in through the nose, the air gets humidified. It’s part of our natural process, that air is humidified when you breathe in through the nose. Now, when someone has a tracheostomy, they’re not breathing in through the nose. Air is not, or oxygen is not getting humidified. Therefore, they’re often hooked up to a humidifier with 37 degrees Celsius, which is around 100 Fahrenheit, right? But that’s often not enough to humidify the air and the oxygen, therefore, a nebulizer is needed and that often comes in the form of a normal saline nebulizer. You can’t go wrong with a normal saline nebulizer. If anything, it helps your loved one by keeping the lungs moist, making them feel comfortable, and being able to cough up their secretions, which is very, very important. Have a look. Sometimes when patients are having a chronic obstructive pulmonary disease (COPD) or asthma, they’re also getting Atrovent or Ventolin, also known as salbutamol nebulizers in the mix, but it is a very important ingredient as part of the ventilator weaning.
Next, number eight, cuff deflation. What do I mean by cuff deflation? So when your loved one is on a ventilator with a tracheostomy, especially in the adult world, not so much with pediatrics, not so much with children, the tracheostomy has a balloon at the end and the balloon is blown up. Basically, what that means is, it stops people from aspirating. That’s number one. Basically, the balloon stops saliva from going into the lungs and it means they’re naturally going into the stomach, which is a good thing. You don’t want saliva going into the lungs. Your loved one could end up with an aspiration pneumonia.
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Now, when someone is weaned off the ventilator and, “only has the tracheostomy”, you want to leave the balloon up to begin with, again, making sure that saliva is not going into the lungs, causing an aspiration pneumonia, but that’s when speech therapy comes in and swallowing assessments come in. Once your loved one has been assessed for swallowing, for speech, then you might be able to take the balloon down slowly and see whether they can swallow. And then you can actually take the balloon down, which enables your loved one to start, hopefully, talking. Okay. And then you need to start working with a speaking valve. And then overnight, you might want to put up the balloon again, put it down during the day, but you can’t really take the balloon down while your loved one is on a ventilator, just simply because the ventilator would leak because the balloon is also there to seal the lungs so that whatever is coming into the lungs stays in the lungs.
Okay. Annely and Panda, I have seen your questions. I’ll just finish off my topic and then I will get to your questions. So that is why you need to know about cuff deflation, but it only comes once your loved one is off the ventilator. Then, the ICU team can look at removing the tracheostomy. Also, once the cuff can be deflated, you could then also start with capping the tracheostomy, which means once you are off the ventilator, the balloon is down, then you can cap the tracheostomy, which forces a patient then to start breathing through the nose and the mouth anyway, because the tracheostomy is capped. If they can achieve that, the tracheostomy can come out.
I just want to note, as a side note, if patients come in with a stroke , seizures, or any neurological condition of head or brain injury, they may be able to be weaned off the ventilator, but they often need a tracheostomy for a while to come because they can’t swallow. That’s why they need the balloon up because if they can’t swallow and they’re swallowing saliva into the lungs, that gets them back on a ventilator very quickly. So that’s why it’s important for you to understand why I’m talking about the balloon up or down.
Next, number nine, if you are in the United States and you have a loved one in intensive care with ventilation and tracheostomy, you might have heard either myself in my videos or blogs talk about that patients often are being sent to LTAC or that the ICU team is pushing you out to LTAC . Now, again, it depends on how much research you’ve done. I am very opposed to LTAC for a number of reasons. I’m not going to go into too much detail, but I just give you the snapshot here. Why am I opposed to LTAC? LTAC is the better version of a nursing home. You can’t go from an intensive care unit being critically ill to an LTAC. In my mind, that’s almost like a criminal offense. I don’t know, those are strong words, but from my experience, I stand by that.
You’re going from intensive care unit to LTAC and it’s just a shocker. You need an intensive care nurse. You need intensive care doctors. If you are having a tracheostomy ventilation, you can’t just let aides look after you or non-ICU trained nurses look after ventilation and tracheostomy. Patients in LTAC just wither away and never get anywhere, they often die. So, what’s the alternative? The alternative is to come back to us and talk about the issue that you want to keep your loved one in ICU and we can help you with strategies. We have many clients that we help to stay in ICU until they wean off the ventilator. The other strategy is to look at services, like Intensive Care At Home.
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And full disclosure here, we are not in the United States yet with Intensive Care At Home. Currently, we are servicing clients on the East Coast in Australia, Melbourne, Sydney, and Brisbane. This is where we are providing Intensive Care At Home. We are branching out into Adelaide and Perth as well, and we will be coming to the United States, but the pandemic certainly slowed things down, even though it increased the demand for Intensive Care At Home, especially in America. So we can’t help you with Intensive Care At Home yet in America, but what we can do is in a few locations, we know people that can do it. So again, contact us and I can hopefully point you in the right direction. Whilst we are advocating for you while your loved one is in intensive care, we can help you manage the strategies. We can help you holding the intensive care team accountable to get your loved one off the ventilator, mapping out the care plans, telling you what needs to happen because intensive care units, unfortunately, become more and more complacent.
Then, talking about Intensive Care At Home, if you have a loved one in intensive care in Australia and you want to look at Intensive Care At Home, again, contact us. We can help you with funding. We can help you taking patients home. We’ve done it over and over again successfully. We can set up the 24-hour roster for you. We can help you with NDIS (National Disability Insurance Scheme) funding. Most of the time, it’s NDIS funding, but there are other funding avenues as well, such as in Victoria, the TAC (Transport Accident Commission), and the DVA (Department of Veteran Affairs). Sometimes it’s privately funded through private health insurances. Sometimes it’s funded through the hospitals directly. Please contact us about that. If you’re an NDIS participant, we can also help you with specialist support coordination. We know how to advocate for funding. We get outcomes for our clients. Otherwise, we wouldn’t be in business. So that’s for our Australian viewers.
Next, and last but not least, I want to come to your questions. Again, I want to thank you for your questions. I’ll just quickly read them out. Sorry, Annely. I’ll come to you in a second, Annely.
Panda, you are saying, “They say she’s fighting the ventilator on and are unable to lower her oxygen still, yet they say she’s fully unsedated now.” Yep. A lot of it there depends, Panda, on how long your loved one has been sedated for? What sedations has she been on? Has she been paralyzed? How long was the coma for? Did they do the tracheostomy in time? Has she had a neurological event? Meaning, has she had a stroke, seizures, brain bleed, or trauma to the brain? So, a lot of it depends on that.
Also, has she had a CT scan and follow up whether there has been a neurological event, such as a stroke, seizures, brain bleed, and so forth? Okay. So, now, Panda, you’re saying, “She was in paralytics and prone with sedation, no neuro event, perfectly fine. Otherwise, they say her left lung is damaged.” Panda, how long was she in an induced coma for?
Annely, just quickly, while I’m waiting for Panda to respond, Annely, I am not a doctor. I am an intensive care nurse with 20 years of intensive care experience, nursing experience.
Panda, almost five weeks. Yeah. Okay. So there are no surprises, Panda, that she hasn’t woken up yet. If she was in an induced coma for five weeks, there are no surprises there.
I’ve written extensively and made videos extensively about how long it takes to wake up after an induced coma. So, I’ve written extensively about that. Especially now, what we are seeing with COVID and people being proned, you need even more sedation when people are being prone and paralyzed, which delays the waking up process. I hope that clarifies. Have a look on our website, and type into, how long does it take to wake up after an induced coma? There’s information there.
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So Panda you’re saying, “The only reason things turned around is, because we begged them to try another treatment and they decided to give her a steroid, which allowed them to flip her back on her back.” Great. Great. If you’ve done that, that’s fantastic. If that’s done the trick for you, that is fantastic.
Okay. Annely, as I said, I am not a doctor. I am an intensive care nurse by background. I have worked in intensive care for over 20 years. Five out of those years, I’ve worked as a nurse unit manager. I’ve consulted families in intensive care all over the world for nine years now. I’m also running an organization, Intensive Care At Home, where we look after long-term ventilated patients at home. So, Annely you’re saying, “The ICU doctor has one objective, it seems, and that is to quicken the end of life situation to progress.” No surprises there, Annely.
Last week, I did a livestream about… No, two weeks ago, I did a livestream about how to avoid or how to stop removing life support for patients in intensive care without family consent. I did a livestream about that. You can go back two weeks and you can watch that.
But again, depending on how much research you’ve done, Annely, you might know how to stand your ground. If not, you should reach out to me after this video and I can show you how to stand your ground when it comes to perceived end of life, because it’s often only perceived. It’s not real. We can help you. I don’t know whether you heard me say earlier that more than 90% of intensive care patients survive. So you really need to ignore the doom and gloom and the end-of-life talk of intensive care teams. They’re not sharing the statistics with you. The statistics are that 92 to 93% of intensive care patients survive. So the odds are in your loved one’s favor.
Okay. So you’re saying, Panda, further you say, “The doctor had a family conference a few days ago and said it’s a very grim situation for her. I didn’t like his vibe. She’s only on diuretics and potassium intravenous (IV). They say she’s fighting the ventilator and are unable to lower her oxygen still, yet they say she’s fully unsedated now.” Yeah. Again, it all comes back to the doom and gloom, Panda. It’s only doom and gloom. It’s only negativity. It’s only positioning. It’s framing and positioning. They want to frame it in a negative light. You can counter-frame and you can counter-position by saying, “Well, I want everything to be done for my loved one!” You just need to stand your ground.
Panda, you were saying, “They were suggesting palliative care, also known as euthanasia.” Yep, couldn’t agree more with you. Euthanasia, unfortunately, is part of intensive care and it’s illegal. It’s illegal. I have, again, written extensively about that. We have helped so many clients avoid the end of life in intensive care. Or if we can’t avoid the end of life, which means some patients do pass away, we can help families getting an end-of-life situation on their terms. But we can certainly advocate for you. Anytime, we can advocate for you in intensive care and we get the outcomes for you.
Panda, “Have you seen patients wake up after several days of sedation?” I have seen patients wake up after several weeks of sedation, after such strong sedation for over four weeks. Yes, but it does depend on what sedation she’s been on. It also depends on what comorbidities she has. It depends on, does she have a liver failure, heart failure, or kidney failure? It depends on a number of things. It’s never straightforward. It’s never straightforward. Okay. But I just want to quickly hone in on what both of you are sharing about the push towards the end of life. You shouldn’t put up with it. You mustn’t put up with it. You need to come to us. We can help you step by step in turning this situation around. We have so much experience in turning perceived end-of-life situations around for families in intensive care.
Intensive care units are very good at pretending that they’re operating in a vacuum. They’re pretending that they’re operating in a vacuum when it comes to the end of life. Well, nothing could be further from the truth. So they can’t just make end-of-life decisions without seeking consent. It’s as simple as that. We can help you through that step by step. We can review medical records. We can show you policies, and procedures. That’s part of our area of expertise.
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Panda, you’re saying, “She has nothing negative going on aside from diabetes, swelling hands and feet, and damaged left lung. They say it’s like a plastic lung rather than rubber.” Yeah, that is happening at the moment after COVID.
So, Annely, “So, you’re saying you could be an advocate on our behalf to the ICU doctor?” Oh, absolutely. That’s what we do. We are talking to doctors, and nurses in intensive care with our clients and on behalf of our clients all over the world every day. It’s part of what we do. Absolutely. That’s our area of expertise. We are professional consultants and advocates. We talk to doctors and nurses directly on our client’s behalf and have the clients on the phone so they can hear what we are saying. We review medical records and point out where there’s potentially negligence, where they’re misleading you and they often do. Yeah.
“How would you go about this?” Annely, I don’t know where you are. Are you in the United States, or where are you? Just let me know where you are. But in any case, it doesn’t matter where you are, Annely. There are phone numbers on our website for different countries and you can call one of those numbers and you get me on the phone. If I don’t answer, just leave a message for me in British Columbus, or in Canada. Yeah. Just give me a call. The number is 415-915-0090. That’s for North America. Again, 415-915-0090, you can call me there. If I don’t answer, leave a message for me. Or you can email me at [email protected]. That’s [email protected].
Now, Panda, you’re saying, “They’re making it seem as though there is no recovering from this damaged left lung. That is my concern. I hope she can pull through.” Yeah. Again, that’s where if you let us talk to the doctors, for example, Panda, we can find out what is exactly happening with the lung. We can review X-rays. We can review chest CT scans. What I will say is this, especially with COVID at the moment, what we are seeing is, that lungs are being damaged. The longer the coma goes on, the higher the risk that lungs are being damaged irrevocably, and that is certainly a challenge. It’s part of the acute respiratory distress syndrome (ARDS) COVID, unfortunately.
We don’t really know what happens with those patients long-term because it’s all relatively new. COVID is still new. You won’t believe it. I think they’re still trying to find out what’s happening with these patients. Do they need a lung transplant? But I’ll give you another tip there. If you have a loved one in intensive care with COVID, COVID pneumonia, or COVID ARDS and they’re being proned, and proning is not working, you need to look at extracorporeal membrane oxygenation (ECMO). You need to look at extracorporeal membrane oxygenation (ECMO). I’m not going into detail about extracorporeal membrane oxygenation (ECMO) now. Just google extracorporeal membrane oxygenation (ECMO) Intensive Care Hotline, and you will find information there. I will actually do a livestream next week, same time about extracorporeal membrane oxygenation (ECMO) in intensive care and about how extracorporeal membrane oxygenation (ECMO) will apply, especially to COVID acute respiratory distress syndrome (ARDS) at the moment.
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So, I’m very conscious of the time. I do want to wrap it up in a minute. If you do have any more questions, please type them in now. Annely, you’ve got my contact details if you want to reach out to me. Go and check out intensivecarehotline.com. If you couldn’t write the number down, the numbers are on the website. The number, Annely, is 415-915-0090. That’s, again, 415-915-0090. That’s in North America. Again, you can also look up that number on our website, intensivecarehotline.com. You’ll find the numbers there.
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Okay. If there are no other questions, I really want to thank you for coming onto this livestream. You can also type below what topics you want to see next. I would appreciate a like for this video. If you liked this video, simply give it a tick. Subscribe to my YouTube channel for more updates for families in intensive care and for more livestreams. I appreciate all your support and your time. Share this video if you think other families in intensive care will get value out of this, and I’m looking forward to talk to you, Annely, when you get a minute.
Take care for now. Thank you so much.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
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Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below! 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 mind blowing tips & strategies helping you to get on the right path to making informed decisions, get PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to you 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 YOUR QUESTIONS ANSWERED episode 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, have a look at our membership site INTENSIVECARESUPPORT.ORG for families of critically ill Patients in Intensive Care here.
Or you can call us! Find phone numbers on our contact tab.
If you want a medical record review, please click on the link here.
Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
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- 5 Ways to have control, power and influence while your loved one is critically ill in Intensive Care
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