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If you want to know what to do if your brother is in ICU with lack of oxygen to the brain after cardiac arrest, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and I have another quick tip for families in intensive care.

So, I have an email from Simone who says, “Hi, Patrik. I have a brother who’s currently in ICU due to lack of oxygen for 30 minutes when he went into cardiac arrest. It has almost been 7 days, and my mother wants to pull the ventilator out and let him die. I need some help here, please. What is the best course of action?”

Simone, I’m very sorry to hear that. Having worked in intensive care and critical care nursing for 25 years, I can see the play that’s at hand here, probably the ICU team is telling your mom that your brother won’t survive and that it’s “in his best interest” to let him die and what you refer to is pull the ventilator out, basically remove life support and let him die.

Now, whilst those situations are very difficult, please keep in mind that having been in ICU for only 7 days after cardiac arrest and potentially what is a hypoxic brain injury here is not a long time, and I encourage you to make decisions today that you don’t regret in 12 months’ time. I can only imagine what an emotionally charged situation this is for you and your family. It’s easy that you feel overwhelmed by the trauma, whether it’s the physical or the emotional trauma that has been sustained for your brother and for you as a family. So therefore, you need to remove emotions, which is much easier said than done for now, and look at the situation logically, think ahead and think, “Okay, if I remove life support today, is that going to be the right decision? Will I potentially regret that in 12 months’ time, in 24 months’ time?”

Keep this in mind, if you remove life support today, you know the outcome, your brother is most likely going to die. If you don’t remove life support, you don’t know what’s going to happen, but what you do know is you will give your brother a chance to improve, whether he can improve or not, I don’t know. But what you do need to find out is, what is his clinical condition right now? Is he still on sedation? If he’s off sedation, what is his Glasgow coma scale, which is a neurological assessment tool to assess someone’s neurological function? If he’s off sedation and his Glasgow coma scale is anything more than a 3, maybe he can improve. If the Glasgow coma scale is 3 and he’s been off sedation for multiple days, then that is certainly concerning.

But there’s so many steps that can be taken and need to be taken, for example, have they done a CT (Computed Tomography) scan of the brain? Have they done an MRI (Magnetic Resonance Imaging) scan of the brain? Have they done an EEG (electroencephalogram) of the brain? Have there been any signs of improvement so far? Is your brother hemodynamically stable, i.e., does he need inotropes, vasopressors, or does he need anti-hypertensives? What is his clinical condition? Also, what has led to the cardiac arrest? Is the cardiologist involved? Is it likely this is going to happen again?

So, you need to sit down with a clinical team and find out exactly what has happened. It’s not good enough for the intensive care team to say, “We should just pull the plug, and we should withdraw life support.” That is not good enough. There needs to be some clinical justification, just as much as there needs to be justification from your end, from your family, and if you wanted to continue, because you also need to involve, or you need to look at what would your brother’s wishes be. Maybe it’s even documented, maybe he’s got an advanced care plan, and once again, 7 days in ICU is not a long time.

If he’s not waking up, there’s the option of him having a tracheostomy. A tracheostomy can buy him time, will help him to mobilize, and will help him to get stimulation. Once a patient gets mobilized in ICU, they have a better chance of waking up.

Also, you as a family need to communicate. What do you want? What is it that your brother would want? I’ll give you another example. So, if you let your brother die, we have so many families come to us, 12 months, 24 months and then saying, “Hey, can you look at the medical records  I’m having second thoughts. Have I done the right thing?” Well, if you’ve got second thoughts after 12 months or 24 months, it’s too late if your brother has passed away by then. The second thoughts you should be having is now.

Here’s two more things. What’s the hurry to kill someone? Where’s the urgency? Where’s the urgency to kill someone? That’s the one point for you to maybe think about. The other thing is, if you go down the track of prolonging treatment, if you go down the track of having a tracheostomy, maybe try and wean him off the ventilator, try and get him stimulation, try and get him occupational therapy, physical therapy, maybe he can wake up, and then if he’s not, there’s plenty of time to talk about end of life, plenty of time. Where’s the rush? Why does the intensive care team is potentially pushing your family into withdrawing life support? Why is that? Because they need the bed.

Intensive care, and intensive care unit’s worst-case scenario is to look after someone indefinitely with an uncertain outcome. Well, that is your brother’s situation, it’s a very uncertain outcome. But their worst-case scenario is actually your best-case scenario, i.e. your brother is going to wake up and he’s going to improve.

Lastly, another thought that I want to leave you with is, is this a real or a perceived end of life  situation? So, what I mean by that is, if it’s a real end of life situation, no treatment, no medications, no surgery, no lifesaving equipment, no nothing will save your brother’s life, that’s a real end of life situation. Your brother’s life is literally slipping through everyone’s hands. Now, every day your brother is surviving, speaks against the theory of the intensive care team that he won’t survive.

If he’s surviving, is there more to merely maintaining the bodily functions, or can he actually wake up? But you will only find that out over time. If that is the case, that is only a perceived end of life situation, not a real end of life situation. So, you need to make a distinction there. Is it real or perceived? I don’t know, I don’t have access to the medical records, I haven’t seen your brother’s case in detail. But keep in mind, every day your brother is surviving, it’s probably a perceived end of life situation and not a real end of life situation.

So, all you need to do there is change the perception and advocate for more treatment and for prolonging treatment, and then you will find out where this is going. But you won’t find out where this is going after 7 days, which is not a long time. If you look back in 12 months’ time, you will understand that 7 days in ICU is not a long time, and that you and your family are probably so emotionally charged at the moment that you shouldn’t make a decision right now, you will probably regret making a decision.

So, I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that on our testimonial section at intensivecarehotline.com, and you can verify it on our podcast section at intensivecarehotline.com, where we’ve done client interviews. That’s why we have helped hundreds and hundreds of members and clients over the years to improve their lives instantly and really save their loved ones’ lives in many instances.

That’s also why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly. When I talk to doctors and nurses directly with you or on your behalf, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com.

We also have an online membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. You also have exclusive access to 21 eBooks and 21 videos that I’ve personally written and recorded. All of that level of support will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment always.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, and share the video with your friends and families.

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Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

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