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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 question from one of our readers and the question last week was
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another question that our readers ask quite frequently and the question this week is
“WHAT HAPPENS IF MY CRITICALLY ILL LOVED ONE CAN’T BE WEANED OFF THE VENTILATOR?”
Having a loved one critically ill in Intensive Care is a very challenging situation to be in. Your worst nightmares, you worst fears, your frustrations, your emotions and your vulnerability are at an extreme level!
You are literally in a “ONCE IN A LIFETIME” situation!
After more than 15 years Intensive Care nursing experience in three different countries and after I have literally worked with THOUSANDS of critically ill Patients and their Families I have found that one of the most frustrating things to watch in Intensive Care is when your critically ill loved one is attached to a ventilator and can’t be weaned off.
And here I need to give you some perspective!
Being in a situation where your critically ill loved one can’t be weaned off a ventilator can come in different facets and different situations.
Let’s shed some light on these different situations where your critically ill loved one can’t be weaned off a ventilator.
- Your critically ill loved one is in an induced coma and has been in Intensive Care for a few days
Now if your critically ill loved one has been in Intensive Care for a few days or up to a week and was initially induced in a coma and is now at the point where they are ready to be “woken up”, it can sometimes be tricky to predict how long it’ll take your critically ill loved one to “wake up” and taken off the ventilator.
Critically ill Patients after an induced coma tend to “wake up” in their own time, no matter how much we wish and hope for them to “wake up” quickly.
Sometimes it can happen quickly within a few hours, but that doesn’t mean that critically ill Patients are alert, coherent, responsive or even follow people’s instructions.
It can sometimes mean that critically ill Patients are restless, agitated, combative, aggressive and confused.
Think about it. If you came to Intensive Care for a critical illness, you were put on a ventilator and you were induced in a coma with strong sedatives(Propofol, Midazolam) and strong pain killers(Morphine, Fentanyl), you wouldn’t wake up smoothly either.
Therefore, “waking up” after an induced coma and weaning off the ventilator is more of a process and not an event. It’s more like switching on a light with a dimmer rather than switching on a light with a switch.
However, to answer your question, natural steps to wean your critically ill loved one off the ventilator is to stop, reduce or minimise sedation, change ventilator settings from a controlled mode, where the ventilator is doing all the work, to an assisted mode, where your critically ill loved one is taking steps to breathe by themselves so that they are basically ready to have the breathing tube removed.
This can sometimes take hours and it can sometimes take days.
It also depends on the underlying cause why your critically ill loved one came to Intensive Care in the first place, why they got ventilated and in the induced coma.
For example, if your critically ill loved one came to ICU with severe head injuries, seizures, stroke or other neurological conditions, “waking up” and weaning off the ventilator is often delayed and difficult as it is often more difficult to assess the neurological or cognitive functionality of your critically ill loved one.
As a rule of thumb, if critically ill Patients are “waking up” normally and they are coherent(i.e obey simple instructions), the ventilator should be weaned within 24- 48 hours and the breathing tube should come out.
If your critically ill loved one isn’t “waking up” even if sedation has been removed and it’s exceeding the 72 hour mark, you need to be patient. I know that’s easier said than done, but know that critically ill Patients tend to “wake up” in their own time.
If it’s coming to the 4- 7 day mark where your critically ill loved one still can’t be weaned off the ventilator, know there are a few options:
- Do a trial extubation (removal of the breathing tube) and see whether your critically ill loved one can cope and breathe without the ventilator
- Consider re-sedation and induced coma to give your critically ill loved one a “rest”, more recovery time and wake them up later
- Consider a Tracheostomy
That leads me to the second scenario where a critically ill Patient can’t be weaned off the ventilator
Related Articles
- Your critically ill loved one has a Tracheostomy tube, is ventilated and can’t be weaned off the ventilator
If your critically ill loved one has a Tracheostomy tube and is still ventilated you will be somehow familiar with the situations that I described in 1)
You and your critically ill loved one may have gone through some or all off the steps that I described in 1)
In any way, you, your family and your critically ill loved one are now facing the dilemma of having your critically ill loved one stuck in ICU with a Tracheostomy and on a ventilator.
It’s one of the most frustrating experiences for critically ill Patients and their families.
Patients tend to have no quality of life, they tend to have a disturbed day and night rhythm and they are often depressed!
Families of those critically ill Patients tend to face a massive dilemma too, because they often put their lives on hold by spending day and night in Intensive Care to be with their critically ill loved one!
Nevertheless, if your critically ill loved one is in Intensive Care with Tracheostomy and ventilator dependent, just like I mentioned in our 1st scenario, critically ill Patients tend to wean off the ventilator in their own time. This can sometimes be over many days, weeks or even months.
Weaning off a ventilator with Tracheostomy in Intensive Care tends to be such a complex, challenging and difficult area that we have dedicated a standalone article just about this topic. I highly recommend that you continue reading this article here in order to get all your questions answered if your critically ill loved one is Intensive Care with a Tracheostomy and can’t be weaned of a ventilator: (click on the link)
Tracheostomy and weaning off the ventilator, how long can it take?
We also have numerous other resources and articles as it relates to ventilation and Tracheostomy, so please check out these resources as well:
How can you have PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care?
You get to that all important feeling of 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 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 “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 “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!
Related Articles
Related Articles:
Why does my loved one need a Tracheostomy in Intensive Care?
HOW LONG CAN SOMEONE STAY IN AN INDUCED COMA?
My 84 year old, PREVIOUSLY ACTIVE father is on a ventilator and the DIALYSIS MACHINE in Intensive Care, will his kidneys EVER RECOVER?
My wife is in Intensive Care VENTILATED with HIGH OXYGEN requirements and with OESOPHAGEAL CANCER, is she going to be OK?
My Mum has been in ICU for three weeks now and she is on ECMO for ARDS! Will she SURVIVE? (PART 2)