Quick Tip for Families in ICU: Why do Critically Ill Patients Need a Tracheostomy in Intensive Care?

Why do critically ill patients need a tracheostomy in intensive care?

My name is 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, control, power, and influence, making sure your loved one gets best care and treatment always, even if you’re not a doctor or a nurse in intensive care.

Today’s The question that is one of our most frequently asked questions and it is. Why does my critically ill loved one need a tracheostomy in intensive care? And this is such a common and important question I get from families in intensive care all around the world every day.

When your loved one has been critically ill, ventilated and unable to come off the breathing tube or the endotracheal tube, the ICU team will often recommend a tracheostomy.

But why? The tracheostomy is usually considered if your loved one has been ventilated for 7 to 14 days and still cannot be weaned off the breathing tube. Some of the reasons can be.

1.  Prolonged ventilation needs.
Your loved one might need ongoing ventilator support beyond the usual time frame.

2.  Difficulty weaning.
Sometimes patients can’t tolerate coming off the ventilator because of weak lungs, weak muscles, or critical illness polyneuropathy or myopathy.

3.  Airway protection
If your loved one can’t manage their secretions or swallow safely, the tracheostomy makes airway management safer.

4.  Patient comfort
Compared to an endotracheal tube in the mouth or nose, a tracheostomy is more comfortable long term, makes it easier to communicate, and sometimes to eat and drink once stable.

Number 5.
They might have ongoing sedation or opiate needs or a combination of both, if your loved one needs Sedation such as propofol, midazolam/Versed, Dexmedetomidine/Precedex, or opiates such as morphine, fentanyl, that will also prolong ventilation with a breathing tube and a tracheostomy.

Next, in some countries. The tracheostomy facilitates ICU step-down. And this is mainly for our audience in the US where tracheostomy is often done prematurely to push patients into LTAC (Long Term Acute Care) or rehabilitation. And that can be the wrong way.

I’ve written about this for many years. I’ve made many videos about this, that a tracheostomy has its time and its place.

There’s nothing wrong with the tracheostomy for the right patient, but there’s something wrong with a tracheostomy, with an early tracheostomy, especially for our clients and audience in the US to then push them onto an LTAC long-term acute care facility , because LTACs are not equipped to look after tracheostomy patients. So be very mindful here.

One of the most important questions you can ask on this journey is How to wean a critically ill patient off the ventilator and the breathing tube.

And I’ve made a video about that, to walk you through that step by step, I will link towards that video in the written version of this blog.

And the next most important question is, what is the ICU team doing to avoid the tracheostomy?

It comes back to the other question, “How to wean a critically ill patient off the ventilator and the breathing tube?” Like I said, I am not opposed to a tracheostomy, right place, right patient, right time, but it should not be the default position to be in. You have to scrutinize, and you have to ask the right question.

The biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for, they don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

So, you must be aware that ICU teams often rush families into consenting for a tracheostomy without explaining all the implications. For example, will your loved one be able to wean off the ventilator? What are the chances of recovery with or without a tracheostomy?

Is the ICU pushing for a tracheostomy because of pain management and discharge pressures rather than patient outcome? That’s why it’s absolutely critical you ask the right questions before making a decision. You need to understand the clinical reasons as well as the hospitals and the ICU’s motives.

And lastly, if your loved one does need a tracheostomy and needs long-term ventilation and tracheostomy, and can’t leave ICU because of that, then I encourage you to have a look at intensivecareathome.com for alternative solutions. That’s again, intensivecareathome.com.

Now, here at intensivecarehotline.com, we have families like yours make these decisions with confidence. You don’t have to feel pressured by doctors and nurses. There’s always time to ask the right questions and weigh up the options.

Go to intensivecarehotline.com now. Call us on one of the numbers on the top of our website, or simply send us an email to [email protected], or book a time with me for a free 15-minute consultation on the website.

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 with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, 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. When I talk to families directly, I also talk to doctors and nurses directly, asking 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 in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a 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. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

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, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

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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.