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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

How Can I Stop The ICU Team From Being Negative Of My Mom’s Condition? HELP!

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 questions from one of my clients Bong as part of my 1:1 consulting and advocacy service! Bong’s mom is in ICU and Bong is asking why the ICU team intend to remove his mom’s breathing tube and disconnect her from the ventilator to die. 

Why Does the ICU Team Intend to Remove My Mom’s Breathing Tube and Disconnect Her from the Ventilator to Die?

Hi Bong,

As I have looked upon how the ICU is managing your mom’s current condition, I agree that they might have an interest in ending your mom’s life and I’ve seen it over and over again.

Intensive care teams generally speaking are overtly negative. They often pay a doom and gloom picture for families in intensive care and if you don’t know how to challenge that, if you don’t know how to ask the right questions, it’s very difficult for you to get the outcomes that you want. Because if anything is going to happen in intensive care teams with their negativity and their doom and gloom, often want to shorten treatment and want to simply withdraw life support, so they can free up an intensive care bed and focus on the next patient that might have a higher chance of recovery.

Can you please send through some pictures of ventilator, bedside monitor, arterial blood gas results, chest x-ray result to begin with. We need to have these information gathered. List of current medications, ideally some blood results.

Kind regards,

Patrik

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Hello Patrik,

I see the pictures on line showing chest physiotherapy where they massage the patients back. The therapists do nothing like that and I have watched them for the past week twice a day.

The therapist just run the machine testing only for spontaneous breathing trials, see the hospital’s weaning procedure. They set the machine and leave the room for hours.  The only therapists are the respiratory therapists. They could care less if mom is awake or asleep. 

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They prefer to leave mom in a drugged stupor 24 /7.  They do not care if she is laying down or sitting up.

There are a few experienced therapists like the one who ran mom at 8 support pressure. I would not be surprised if she has been disciplined for doing so.

Each therapist does just what the doctor ordered, they know nothing about weaning procedures.  They are trained by the hospital.

Young trainees accompany them. If the hospital protocols do not list it they are not doing it.  You may want to see hospital’s training manual. Hospital will be no different than any other hospital here in our place.

The report has ventilator data they set those values and leave. They look for pressure support which is 10 during testing, PEEP, Tidal volume, O2 and failure to breath.

Instead of a picture of the ventilator screen how about I ask for a print out of all settings since the start. If there is something else you want to know let’s see what they are doing or not doing at resting periods and during their trial periods.

Regards,

Bong 

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Hello Bong,

As for your current email, please see details below.

1. I see the pictures on line showing chest physiotherapy where they massage the patients back. The therapists do nothing like that and I have watched them for the past week twice a day. The therapist just run the machine testing only for spontaneous breathing trials, see the Hospital weaning procedure. They set the machine and leave the room for hours. The only therapists are the respiratory therapists. They could care less if Mom is awake or asleep. They prefer to leave Mom in a drugged stupor 24 /7. They do not care if she is laying down or sitting up.

– One best way to improve your mom’s breathing effort is thru Chest Physiotherapy. If this is ordered by the doctor (depending on the hospital protocol), the respiratory therapist should be religiously doing this and needs to be properly documented as well with their clinical assessment of your mom pre-CPT and post-CPT. If they are doing procedures like for the SBT (Spontaneous Breathing Trial), your mom needs to be strictly monitored for good assessment. With the condition of your mom, she needs to have OT/PT for rehabilitation starting this time for support and you can request it to them and they should be explaining to you their reasons for not being able to perform it.

2. Today the ICU will have the reports like you have already received showing everything. Do you want older reports?

– Yes, if you could provide me with those, that would be great! I want to see your mom’s progress from the start and what lead to failed SBT’s.

3. There are a few experienced therapists like the one who ran mom at 8 support pressure. I would not be surprised if she has been disciplined for doing so. Each therapist does just what the doctor ordered, they know nothing about weaning procedures. They are trained by the hospital. Young trainees accompany them. If the hospital protocols do not list it they are not doing it. You may want to see Hospital’s training manual. Hospital will be no different than any other hospital in our place.

– They should know what they are doing and you can ask them that because your mom needs to have the right care and treatment.

4. Instead of a picture of the ventilator screen how about I ask for a print out of all settings since the start. If there is something else you want to know let’s see what they are doing or not doing at resting periods and during their trial periods.

– I would like to see the picture itself because I’d like to see your mom’s breathing volume, effort, rate and every important detail that is currently registered in the monitor of the ventilator with the current ventilator setting she’s on and normally, that is not being documented in the report. If you could provide me with the print out of all settings, I would also accept that. One important thing as well is the result of the recent arterial blood gas or any other most recent blood gas. Picture of the bedside cardiopulmonary monitor and any other machine available at the bedside.

Thank you.

Kind regards,

Patrik

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Hi Patrik,

Attached is the hand written information about mom’s latest lab & x-ray. I will attempt to down load the pictures I took.

The hospital has informed me they intend to remove mom’s breathing tube and disconnect her from the ventilator to die even though she is alert and awake and can communicate.

Hopefully I can get a court injunction.

Regards,

Bong 

Hi Bong,

Thank you Bong for the lab notes.

As per your email:

The hospital has informed me they intend to remove mom’s breathing tube and disconnect her from the ventilator to die even though she is alert and awake and can communicate. Hopefully I can get a court injunction.”

– I’m shocked reading that. Did they tell they INTEND to remove the breathing tube for her TO DIE? That’s MURDER! They should SAFELY remove the breathing tube and disconnect her to the ventilator BY ALL MEANS! We are dealing with lives here!

You can have a court injunction or you yourself can make it stop (REFUSAL OF TREATMENT/PROCEDURE) if your mom is NOT extubatable yet.

Important parameters need to be met: Stable vital signs, stable blood gas result, good chest x rays, fully awake, stable spontaneous breathing effort.

If she failed to meet any of those, then she’s not for extubation and might take some time still to achieve that but she can achieve that given enough time.

I will wait for your update and any additional clinical info you may provide.

Kind Regards,

Patrik

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Hi Patrik,

Thank you for your concern.

The hospital will base its claims to the Court upon their doctor’s expertise and their ethics committee whom I spoke before yesterday. Those presentations were verbal where those representing the hospital made inaccurate and misleading claims.

Their notice letter was equally inaccurate and was based upon irrelevant issues.  As amateur as their presentation and notice were I have nothing to confront their claims. Just vague promises that something will be forthcoming that lays out proper medical treatment.

I realize now that hospital does not have a protocol to properly wean someone like mom off a ventilator because it can take weeks, so they mislead patients and force them off to either die or get a tracheostomy and move to a long term care facility. This is why I see their respiratory therapists doing whatever they like with no plans.

Hospital will be no different than any other hospitals in our place and in how they treat patients on ventilator.

Either the patient is strong enough to extract themselves from the ventilator when off sedatives or they are thrown out with no meaning full treatment.

Regards,

Bong 

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Hi Bong,

Thank you for the update.

As per your email:

I realize now that hospital does not have a protocol to properly wean someone like mom off a ventilator because it can take weeks, so they mislead patients and force them off to either die or get a tracheostomy and move to a long term care facility. This is why I see their respiratory therapists doing whatever they like with no plans. 

Ventilator weaning differs from every patient. Yes, the hospital may have a protocol but they do not follow that as what most ICUs do. It’s a case to case basis. We see that all the time, forcing families to sign papers for their loved ones to die or just push them out to LTAC or long term care facility.

You have to learn how to manage the intensive care team and not them managing you. Most families in intensive care feel completely intimidated and helpless. You should be able to know what questions you need to ask and we as your professional consulting advocacy here at the intensive care hotline, we can help you very quickly to make informed decisions get peace of mind control, power and influence in these situations.

What you need to do now, is to let them know that you are ALL for making your mom to LIVE and do whatever possible way for her recovery. 

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We’ve done advocacy and consultancy for many years now and we’ve seen hundreds of critical patients recovered and go home in stable condition and we’re hoping we could do the same with your mom as well.

Regards,

Patrik

The 1:1 consulting session will continue in next week’s episode.

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 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.

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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