Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

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 Dad’s Pressure Sores Worsened In The ICU. How Come The Nurses Didn’t Prevent Them?

You can check out last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED“  I want to answer the   questions from one of  my clients Caroline as part of my 1:1 consulting and advocacy service, whose fiancée is in the ICU and ventilated but the ICU team is rushing him into a tracheostomy. 

The ICU Team Keep On Insisting Charly To Have A Tracheostomy. Why Not Wean Him Off  The Ventilator First? 

Tom:  Hello.

Patrik:  Hi. It’s Patrik here from Intensive Care Hotline.

Tom:  Yes, can you hold? I’m going to put you hang on the phone.

Patrik:   Thank you. Thank you.

Tom:  Patrik is on the phone with us.

Caroline:  What?

Tom:  Patrik’s on the phone. He called back.

Caroline:  Okay.

Tom:  Patrik?

Patrik:   Yes. Can you hear me?

Tom:   Yes.

Caroline:   Yes.

Patrik:  Okay. Number one, I thank you so much for being a client. I really appreciate it. We can get on to resolving some of the issues straight away. I think the first most pressing question, and tell me if I’m wrong, would be the issue around tracheostomy, whether that would be appropriate or not.

Recommended:

• Book your free consultation call here

• Check out our Ebooks and videos

Caroline:   Yes, that was the question.

Patrik:   There are two very important things to understand here. Number one, a tracheostomy has its time and its place if ventilation can’t be weaned, okay? You are correct that the two-week mark is sort of the cut-off where people need to decide if a tracheostomy is the right thing to do or not, but the number one priority with a tracheostomy should always be not to use it. It should be a last resort and the goal should always be to wean somebody off a ventilator in the first place and wean the breathing tube and the ventilator. That should always be the goal, okay?

Recommended Links: 

• WHAT ARE THE RISKS AND BENEFITS OF A TRACHEOSTOMY?

• FOLLOW THIS PROVEN SYSTEM TO AVOID THE 3 MOST DANGEROUS MISTAKES YOU ARE MAKING BUT YOU ARE UNAWARE OF, IF YOUR LOVED ONE REQUIRES LONG-TERM VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

• HOW TO WEAN A CRITICALLY ILL PATIENT IN INTENSIVE CARE OFF THE VENTILATOR AND THE BREATHING TUBE!

• THE 7 ANSWERS TO THE 7 MOST FREQUENTLY ASKED QUESTIONS IF YOUR LOVED ONE REQUIRES ONGOING MECHANICAL VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

Caroline:  Yes.

Patrik:  Now I don’t know whether that has happened or not and-

Caroline:  They haven’t done that at all.

Patrik:  Right. Why do you think they haven’t done that? Have you got any indication?

Caroline:  I don’t know. They keep saying that they believe that they should do a tracheostomy. That’s what the nurse just told me earlier. That’s why I particularly wanted you to speak to me. They said that they think that his brain is now gone, that his lungs could breathe so they think that the tracheostomy is the best thing to do.

Related Links:  

• HOW TO WEAN OFF VENTILATION AND TRACHEOSTOMY STEP BY STEP! TRACHEOSTOMY AND WEANING OFF THE VENTILATOR IN INTENSIVE CARE, HOW LONG CAN IT TAKE?

• WHAT THEY DON’T TELL YOU IN INTENSIVE CARE WHEN IT COMES TO WEANING FROM TRACHEOSTOMY AND VENTILATION!

• CAN A TRACHEOSTOMY BE REVERSED?

My grandmother was in ICU three weeks ago and we asked them could we have the weekend to give her a little bit more time and when they did the extubation, she would be … They were weaning her and then they were able to do the extubation, so I don’t understand why they haven’t tried to do that in this case to see if he can breathe.

Patrik:   Correct.

Caroline:   He’s been breathing on his own. He’s been breathing. His number is 20 on the vent so-

Patrik:  Right. Have they started to mobilize Charly? Have they started to get him out of bed, for example?

Caroline:  No. No, they haven’t done anything. They just move him, shift him occasionally. They keep massaging on his feet. They haven’t tried to have him out of the bed or at least sit him up in a chair, something like that.

Patrik:   Right.

Caroline:  He’s just been in the bed this whole time.

Patrik:   Okay. Do you think he could be mobilized?

Caroline:  I think he can be but when he is moved, his blood pressure does go up. Then they’ve been giving him, every time it goes up, they give him Ativan, Ativan, Ativan.

Patrik:   Um-hmm (affirmative) and that’s knocking him back.

Caroline:   Yeah.

Tom:   What do you mean by mobilize. I don’t know what you’re talking about.

Caroline:  They could put him in a different position, right?

Patrik:  Yeah, I think the goal is, with getting somebody off the ventilator and the breathing tube, it’s always number one, through physical therapy, physical therapy for the chest in particular, number two, getting them out of bed if they can, sitting them up, stimulating them, all of that. If getting him off the ventilator and breathing tube can’t be achieved, and in some instances, it can’t be achieved, but obviously, they need to try their very best to achieve that. Then a tracheostomy might be appropriate. However, here is another question. Have they mentioned anything about long-term acute care?

Suggested Links:

• INTERVIEW WITH CHARLIE ATKINSON WHO WAS A PATIENT IN ICU & LTAC FOR MORE THAN 12 MONTHS AND SURVIVED AGAINST THE ODDS! LISTEN TO CHARLIE’S INSPIRATIONAL STORY!

• INTERVIEW WITH ILEANA WHOSE MOTHER PASSED AWAY IN LTAC AFTER ICU STAY!

Caroline:   Not yet, no. I think that the goal is once they do the tracheostomy, that would be the next conversation.

Patrik:   That has been brought up as a point of discussion, has it?

Caroline:  Very, very frustrating, but I will say physical therapy was here about five days ago and I asked them if they could do something for him. All he did was shout, “Charly! Charly!” He didn’t do anything. It was very basic. I even asked if accupuncture would help him in some kind of way or something and he said, well no, he didn’t think Eastern medicine would work at all. That’s the last time I saw him.

Patrik:   That’s terrible because the physical therapy should be a daily thing. That’s very disappointing that the physical therapist comes and says, well, they don’t think they can do anything. That’s terribly disappointing.

I’ll tell you what I’ve experienced over the years and that’s really important to understand. The tracheostomy is often a vehicle for an ICU to empty their ICU and get on to long-term acute care. That, from my perspective, is not the best way forward because … Do you know what happens in long-term acute care? Have you got any ideas?

Caroline:  Well, isn’t that just a way to put you in a facility to wait for you to pass?

Patrik:  No, not necessarily, not at all. The goal is always to wean somebody off the ventilator but the problem is you’re going from an ICU with ICU doctors, ICU nurses with respiratory physicians, all of that, or respiratory therapists. You’re then going to a long-term acute care facility where there’s one doctor for 30 patients and no ICU nurses.

Suggested Articles:

• Why The Doctors In Intensive Care Are Looking For A Solution For Their ICU And Why You Are Looking For A Solution For Your Critically Ill Loved One And How To Get What You Want In This Power Struggle!

• PODCAST: ICU WANTED TO TRANSFER MY DAD IN THE LTAC FACILITY BUT I WAS ABLE TO KEEP HIM IN THE ICU. YOUR PROFESSIONAL CONSULTING AND ADVOCACY DID HELP ME A LOT! (Rachel case study)

Caroline:   Oh, no. Yeah.

Patrik:  The drop in skills is significant and therefore, yes, tracheostomy again has its time and its place, but many ICU’s use it to send patients out of intensive care as soon as possible without actually looking at the clinical needs. That’s why it’s so important that patients get weaned off the ventilator in the first place and avoid the tracheostomy. The reality is the minute somebody has the tracheostomy, they often line up the patient in long-term acute care a few days later. That’s from my perspective, is inappropriate.

Caroline:  Yeah.

Patrik:  Has Charly’s dad, has he even consented to the tracheostomy already?

Caroline:  We didn’t want him to so he said no. They asked me again tonight and I said, “I don’t know what’s going on, so you can stop asking me about it.”

Patrik:  Right, right, so no consent has been given yet.

Caroline:  No. They’re asking me now so that they can pull his feed.

Patrik:   What do you mean by pulling his feed? What do you mean by that?

Caroline:  They said that they’re trying to find out from the father if they can go ahead with the surgery, so they can turn his feeding off.

Patrik:  Oh, sure, sure. I see now. I’m with you. I’m with you. Okay.

Caroline:   I said, “I don’t know. I don’t know, so they can just, keeping the feeding on.”

Patrik:  Yeah, sure. That is what happens before they do a tracheotomy. They do stop the feed for 12 to 24 hours prior, but then if Charly’s dad hasn’t given consent, there’s not much they can do, either.

Tom:  Charly’s dad maybe hears what we have to say also.

Patrik:   Okay, good. No, that’s good. From that perspective, another question is do you know if Charly is still on any sedation or not?

Recommended Informations:

• Why Would A Critically Ill Patient In An Induced Coma Need A Tracheostomy In Intensive Care?

• How long can you keep a critically ill Patient in Intensive Care in an induced coma

• “AFTER WEANING OFF A VENTILATOR IS IT NORMAL TO BE CONFUSED?”

• MY 78 YEAR OLD MOTHER HAD TWO CARDIAC ARRESTS, ARE THEY KEEPING HER VENTILATED AND SEDATED FOR TOO LONG?

Caroline:  No, he hasn’t been on sedation for a few days now. They took him completely off of that.

Patrik:   Right, and what about the Ativan? How often do you think they’re giving that?

Caroline:   It seems as though they’re giving Ativan whenever they see him shaking. The last he’s had Ativan in the last 12 hours in time.

Patrik:  Right, okay. Any change in his response to you since we last spoke?

Caroline:   Well, last night when I was here … I stayed over at the hospital, so I was here the whole time. I noticed that … I took a pin to his foot, from the bottom to the top and he moved it a lot. He has never done that before. He has never done that before at all.

Patrik:   That’s good.

Caroline:   I was holding his hand and he grabbed my hand twice, not like a jerking motion. It was like he was holding my hand twice. Then his fingers moved and then it stopped. Then I also noticed that … His eyes right now are closed, right? There was one point in time where one eye opened and then the other eye opened and he kept them open for two minutes straight and one eyeball looked like it was moving very little to the left, now very little, so he had his eyes opened for two full minutes. I counted, and I recorded with my camera. He made so many foot movements yesterday, I have at least 15 minutes of video where he moved his foot at least 12 times.

Patrik:  That’s great. That’s great. That’s good.

Caroline:  That’s why I think that he is trying. I know that we’re in a situation where I don’t want to be rushed, but I do want to do what’s best for him.

Patrik:  Yep, absolutely.

Tom:  Let me ask you a question, Patrik. If stimulation, if you take something like a small device and you run it on someone’s foot and he is in a coma, will it cause him to move or is that something that he has to have feelings for?

Patrik:   No, he doesn’t have feelings for this device. You see, when patients are in a coma, there are no hard and fast rules because individuals are very different. It also depends on how much brain damage there is. There may be no brain damage. I remember you mentioning last week that there potentially is brain damage but the biggest problem is that the ICU wants Charly to recover in a time frame that’s convenient for the ICU, right? The reality is Tom will need time or any other patient, for that matter, needs time. People are people. They are individuals. No amount of pressure will get Charly to recover quicker.

Recommended links:

• THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO “LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT”, “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!

• THE 10 THINGS YOU DIDN’T KNOW ARE HAPPENING BEHIND THE SCENES IN INTENSIVE CARE THAT HOLD YOU BACK FROM HAVING PEACE OF MIND, CONTROL, POWER AND INFLUENCE, WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

Caroline:   Yeah, I agree.

Patrik:   As you know, Charly, yes, he’s moving now his legs. In two days’ time, he might move his arms. There’s no textbook around how long it takes for a patient to recover in a situation like that. Nobody has a crystal ball to say, “Yep, this is going to take two weeks, two days, two months.”

Tom:  What do you think should be done at this point?

Patrik:   Say again?

Tom:   What should be done at this point?

Patrik:    Yeah, I’ll tell you what-

Caroline:   I’m sorry. Hold on one second. I’m sorry. The doctor is here now. He has been trying to call him, too.

Patrik:  Okay, well, if you need to interrupt, let me know and I can call you back.

Caroline:  Yes, can you just give me a call right back, please? I’m sorry.

Patrik:  Yeah, sure. I’ll call you back. Sure.

Caroline:  Okay.

Patrik:  Thanks.

Caroline:  All right. Thank you.

Patrik:   Thanks.

Caroline:   All right.

Tom:    Hello?

Patrik:    Hi,Tom. It’s Patrik again.

Tom:   Okay, shall I put him on you right now?

Patrik:   Yes, yes. Absolutely.

Tom:   Okay.

Caroline:  Yes, hello?

Tom:  Hello?

Patrik:   Hello.

Tom:   Patrik?

Patrik:  Yes, I can hear you.

Caroline:   Oh yes, sorry. He was looking for me, asking me again.

Patrik:   Right, right. So I think the last thing that you asked, Tom, was what should happen? So to put this in a nutshell, number one, they should maximize their chances to get him off the ventilator and the breathing tube. And if it can’t be achieved, fair enough, let’s do a tracheostomy. But even if he ends up with the tracheostomy, it’s then to be prepared for the next step, which would be to stop them from going to long-term acute care.

The reason why I feel so strongly about not going to long-term acute care is the reality is an intensive care unit is much better equipped and much better skilled to wean somebody off the ventilator than a long-term acute care facility, right? So but, let’s take one step at a time, and number one, make sure they can wean him off the ventilator and the breathing tube if they can. And again, if that fails, fair enough. If they’ve given it a good go, fair enough. Let’s look at the tracheostomy. But for now, it sounds to me like they haven’t even tried to get him off the ventilator and the breathing tube in the first place, it sounds. Is that how you feel?

Recommended Topics:

• THE 10 THINGS YOU DIDN’T KNOW DOCTORS AND NURSES ARE TALKING ABOUT IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE, WHEN YOU AND YOUR FAMILY ARE NOT PRESENT AT THE BEDSIDE!

• FOLLOW THIS PROVEN 6 STEP PROCESS, ON HOW TO BE POWERFUL, IN CONTROL, INFLUENTIAL AND HAVE PEACE OF MIND, IF YOUR LOVED ONE IS A LONG-TERM PATIENT IN INTENSIVE CARE OR IS FACING TREATMENT LIMITATIONS IN INTENSIVE CARE!

Caroline:   Yes, they haven’t. Yes, I do, I have a question for you.

Patrik:   Yes.

Caroline:  If they say, “Okay, we’ll try to wean him off,” and things of that nature, I’m going to make sure I’m there to witness it, if I’m not, I’m going to get Charly in there. So the question would be, let’s say they wean him off completely, and an hour goes by, and he breathes, and then the second hour comes and he can’t do it, what would the option be at that point for them to do? Would it be the tracheostomy at that point?

Patrik:   Yes, so if that happens, right, he would end up with the breathing tube again, and then he would have a tracheostomy. So there is no way that they could do a tracheostomy without the breathing tube in place, right? So if, for whatever reason, he fails extubation, extubation is the term for having the breathing tube removed, let’s just say-

Recommended Links: 

• MY FATHER HAS BEEN WEANED OFF THE VENTILATOR IN INTENSIVE CARE AND STILL HAS THE TRACHEOSTOMY IN. WHEN CAN THE TRACHEOSTOMY BE REMOVED?

• QUALITY OF LIFE NURSING SERVICES FOR VENTILATED ADULTS WITH TRACHEOSTOMY AND THEIR FAMILIES AS A GENUINE ALTERNATIVE TO INTENSIVE CARE

• TRACHEOSTOMY CARE AND TRACHEOSTOMY CARE IN THE COMMUNITY

Caroline:   Get removed, yes.

Patrik:  He fails extubation, yes, they would put the breathing tube back in, and then he would have a tracheostomy. However, I do strongly believe that if that happens, they’ve tried, and then you know that the tracheostomy is the right decision.

Caroline:   Now, would that be a problem for him to get re-intubated, to then get a tracheostomy? Would that put too much pressure on the body?

Patrik:   No, probably not. Probably not.

Caroline:  Okay.

Patrik:  I’m a strong believer that’s what’s called a trial extubation is important, to not rush into a tracheostomy.

Recommended:

• 1:1 Email counselling and consulting with Patrik

• 7 days unlimited 1:1 phone consulting and advocacy

• Membership for families in Intensive Care

• 1:1 phone and email counselling and consulting with Patrik

Caroline:   Yes, okay.

Tom:    Okay.

Caroline:   Alright, I guess, yes, it seems …

Patrik:   You know what, if you can send me a picture of the ventilator, that would be very, very helpful, because then I can tell you how far away he is from being extubated.

Caroline:    Oh, okay. Alright, well, all I know-

Patrik:  That would be very helpful.

Caroline:   He is consistently at 20. That’s all I … And he’s done more than that. The most he’s done is 34.

Patrik:   Okay, do you know- 

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?

You get to that all important feeling of making informed decisions, get PEACE OF MIND, CONTROL, POWER 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 make informed decisions, get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care!

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 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 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.

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!

Related Articles:

• What is an induced coma and why is my critically ill loved one in an induced coma

• How LONG does it take to WAKE UP after an induced coma?

• How LONG can someone stay in an INDUCED COMA?

• How long can you keep a critically ill Patient in Intensive Care in an induced coma

• How long can a breathing tube or an endotracheal tube can stay in

• The 10 COMMANDMENTS for PEACE OF MIND, control, power and influence if your loved one is critically ill in Intensive Care

• Tracheostomy and weaning off the ventilator in Intensive Care, how long can it take?

• Why do doctors in Intensive Care insert a Tracheostomy after an induced coma?

• How long should a Patient be on a ventilator before having a Tracheostomy?

• Why does my loved one need a Tracheostomy in Intensive Care

• What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up?

• My 80 year old father is in Intensive Care with Myeloma! The Intensive Care team HAS ASKED ME TO SIGN A “DNR” AND I REFUSED! What are MY OPTIONS?

• The 3 most dangerous mistakes that you are making but you are unaware of, if your loved one is a critically ill Patient in Intensive Care

• The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”

• HOW TO STOP BEING HELD HOSTAGE BY THE INTENSIVE CARE TEAM if your loved one is critically ill in Intensive Care!

• HOW TO CONTROL YOUR POSITIVE SELF- IMAGE whilst your loved one is critically ill in Intensive Care

• How long does it take to wake up from a Traumatic brain injury or severe head injury

• 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

• Does my critically ill loved one in an induced coma or with head injuries feel my presence?

• My 25 year old wife has been in ICU for one month with Tracheostomy and is still in an induced coma

• My Mum has been diagnosed with STOMACH CANCER and is in ICU ventilated. CAN I TAKE HER HOME on a ventilator?

• The questions you need to ask the most senior doctor in Intensive Care, if your loved one is critically ill in Intensive Care

• A 5 step BLUEPRINT for DYING WELL and with DIGNITY in Intensive Care

• How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed

• Why you must make up your own mind about your critically ill loved one’s situation in Intensive Care even if you’re not a doctor or a nurse!

• The ELEPHANT IN THE ROOM or HOW THE INTENSIVE CARE TEAM IS MAKING DECISIONS whilst your loved one is critically ill in Intensive Care!

• MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO?

• 5 ways you are UNCONSCIOUSLY SABOTAGING yourself whilst your loved one is CRITICALLY ILL in Intensive Care and HOW TO STOP doing it!

• How to make sure that “what you see is always what you get” whilst your loved one is critically ill in Intensive Care

• 5 steps to become a better negotiator if your loved one is critically ill in Intensive Care

• 5 Ways to have control, power and influence while your loved one is critically ill in Intensive Care

• 6 phrases you should never say when your loved one is critically ill in Intensive Care

• How to REPROGRAM YOUR MIND if your loved one is critically ill in Intensive Care

• How to play a “HIGH STAKES GAME” that only the Intensive Care team knows HOW TO WIN!

• Family overjoyed as top court rules doctors must seek consent before taking a patient off life support

• How to make sure that your values and beliefs are known whilst your loved one is critically ill in Intensive Care

• My loved one has HIV, lymphoma on his brain, seizures, septic and is ventilated! The Intensive Care team is trying to TAKE MY HOPE AWAY and they are all NEGATIVE! HELP!

• MY PARTNER IS IN INTENSIVE CARE AFTER A BLEED ON A BRAIN! WE ARE WORRIED THAT THE INTENSIVE CARE TEAM WANTS TO SWITCH OFF THE VENTILATOR! HELP!

• CAN YOU GO HOME ON A VENTILATOR?

• HOW TO DEAL WITH A DIFFICULT INTENSIVE CARE TEAM, WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

• DISRUPT before you are being DISRUPTED, whilst your loved one is critically ill in Intensive Care!

• HOW TO STAY STRONG WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!”

• What the doctors and the nurses behaviour in Intensive Care is telling you about the culture in a unit

• How to take control if your loved one has a severe brain injury and is critically ill in Intensive Care

• Family Meetings in Intensive Care or the Elephant in the Room

• How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)

• How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2)

• The four DEADLY SINS that Families of critically ill Patients in Intensive Care CONSTANTLY MAKE, but they are UNAWARE OF!

• My HUSBAND had a HORRIBLE work accident and went into CARDIAC ARREST! Will he be PERMANENTLY DISABLED

• HOW TO GET AN UNFAIR ADVANTAGE whilst your loved one is critically ill in Intensive Care!

• How to MUTE your NEGATIVE INNER DIALOGUE whilst your loved one is critically ill in Intensive Care!

• Why decision making in Intensive Care GOES WAY BEYOND your critically ill loved one’s DIAGNOSIS AND PROGNOSIS!

• How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS

• WHAT HAPPENS IF MY CRITICALLY ILL LOVED ONE CAN’T BE WEANED OFF THE VENTILATOR?

• The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care!

• How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care!

• CAN I TAKE MY LOVED ONE HOME ON A VENTILATOR TO DIE?

• The 5 ways how RESILIENT FAMILIES in Intensive Care STAND BACK UP when life knocks them down!

• Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care

• The 5 QUESTIONS you need to ask, if the Intensive Care team wants you to DONATE your loved one’s ORGANS in an END OF LIFE SITUATION!

• MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART 1)

• How MEDICAL RESEARCH DOMINATES your critically ill loved one’s diagnosis and prognosis, as well as the CARE and TREATMENT your loved one IS RECEIVING or NOT RECEIVING

• 5 things NOBODY HAS EVER TOLD YOU about Intensive Care

• WHAT WOULD YOU DO if you knew that you COULD NOT FAIL, whilst your loved one is critically ill in Intensive Care

• How the Intensive Care team is SKILFULLY PLAYING WITH YOUR EMOTIONS, if your loved one is critically ill in Intensive Care!

• My father is in Intensive Care ventilated with LIVER FAILURE and KIDNEY FAILURE, I DON’T THINK HE WILL SURVIVE! HELP

• HOW TO GIVE YOURSELF PERMISSION TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

• My father has been weaned off the ventilator in Intensive Care and still has the Tracheostomy in. When can the Tracheostomy be removed?

• HOW LONG DO YOU NEED TO BE ON A VENTILATOR AFTER A LUNG TRANSPLANT

• HOW LONG can a critically ill Patient stay on ECMO?

• THE ULTIMATE FASTLANE TO PEACE OF MIND, CONTROL, POWER AND INFLUENCE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!