My name is Patrik Hutzel from intensivecarehotline.com and you’re watching my YouTube channel.

Here at intensivecarehotline.com, 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 always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

Now today I have an email from Sarah who says.

“Hi Patrik,

My dad is in an induced coma because of a brain stroke. He’s in ICU now and he’s on a ventilator. Upon arrival, the hospital made a CT scan, but now the ICU team is insisting on the CT being very dangerous since he’s on a ventilator. Also, they keep saying that moving him can be fatal and the CT is not necessary because the caring procedure will remain the same even if bleeding is still ongoing.

What should we do?

– Sarah.”

Now Sarah, thank you for your question. Your dad is in ICU with a stroke. He’s in an induced coma; he’s on a vent and now we’re getting conflicting messages about CT scans and moving him. The ICU team is saying it’s dangerous to move him for a CT scan, but you need answers. Let me break this down for you.

Let’s first of all look at understanding brain stroke types, ischemic versus hemorrhagic. First, there are two main types of strokes, and the treatment is completely different for each.

Ischemic stroke is caused by a blocked artery in the brain. Treatment options include clot-busting medications like TPA (tissue plasminogen activators), if given within the first few hours, mechanical thrombectomy to physically remove the clot, blood thinners to prevent further clots, and supportive care, including managing blood pressure and maintaining oxygen levels.

The other form of stroke is a hemorrhagic stroke which is caused by bleeding in the brain. Treatment focuses on stopping the bleeding, managing blood pressure very carefully, often lowering it, potentially neurosurgery to remove blood clots or repair blood vessels, medications to reverse blood thinners if they contributed to the bleeding and monitoring for increased intracranial pressure.

This is exactly why knowing what type of stroke your dad has and whether there’s ongoing bleeding matters tremendously, Sarah.

Let’s now look at when CT scans are necessary versus when moving is actually dangerous.

Moving a critically ill patient on ventilators does carry risks, including brief drops in oxygen levels, blood pressure changes, accidental dislodgements of tubes or lines, which can be fatal, and also increased intracranial pressure in brain injury patients, which is what stroke patients are.

However, saying a CT scan is not necessary because treatment won’t change is questionable reasoning. Here’s why a repeat CT scan might be absolutely critical. It shows if bleeding is ongoing or stopped, reveals if there’s new bleeding or stroke extension, identifies swelling, also known as cerebral edema, that might need intervention, shows up if there’s hydrocephalus, fluid build-up, requiring a drain, and guides prognosis and treatment decisions.

The statement that treatment won’t change is often not accurate. If there’s ongoing bleeding, blood pressure management becomes even more critical. If there’s significant swelling, neurosurgical intervention like decompressive craniectomy might be needed. If there’s hydrocephalus, an external ventricular drain, also known as an EVD, could be lifesaving.

And I can tell you from my extensive experience that modern ICU teams routinely and safely transport ventilated patients for CT scans every single day all around the world. With proper preparation, portable monitoring, manual ventilation or transport ventilators, and experienced staff, the risks are manageable and often outweighed by the diagnostic benefits.

And here’s my advice, Sarah, request a clear explanation. Ask the ICU team specifically why they believe the CT scan risks outweigh the benefits in your dad’s case. What specific instability makes him too unsafe to move? Ask what clinical decisions they’re making without knowing if bleeding is ongoing. How are they managing blood pressure targets without knowing the current brain status.

Also, what they can do if they’re worried about high blood pressure, high intracranial pressure, they can sedate your dad, put him on more opiates, more sedatives, and potentially even paralyze him. Now these are last resort measures, but I’ve seen this in having worked in critical care nursing for over 25 years.

But this is also why having access to all medical records becomes absolutely crucial. You need to see the initial CT report, current vital signs, ventilator settings, sedation levels, and neurological assessments. You cannot make informed decisions or effectively advocate without complete information.

A consulting call with myself or someone from our intensivecarehotline.com team, ideally with the ICU team on the other end, will help clarify these critical questions. We can review the medical records together, understand the specific risks versus benefits in your dad’s situation, question the reasoning behind avoiding the CT scan, and advocate for appropriate monitoring and interventions.

We do this every day for families in intensive care all around the world. We help you understand what’s really happening, what questions to ask, and how to ensure your dad gets the best possible care and treatment.

Depending on your dad’s stroke type and severity, treatment in ICU will focus on brain protection, preventing secondary injury, managing blood pressure precisely high or low blood pressure, depending on stroke type, controlling intracranial pressure if elevated, preventing complications like pneumonia and blood clots, and gradual awakening and neurological assessments.

Some stroke patients recover quickly; others need prolonged ventilation and intensive rehabilitation. If your dad ends up needing long-term ventilation, whether that’s invasive with a tracheostomy or non-invasive ventilation on BiPAP (Bilevel Positive Airway Pressure), CPAP   (Continuous Positive Airway Pressure) with a mask, or if he requires a tracheostomy without ventilation because he can’t be weaned off the ventilator, you need to know about Intensive Care at Home, and you can find more information at intensivecareathome.com.

Intensive Care at Home is a long-term option to keep your dad out of ICU predictably and permanently, whether he needs ongoing ventilation support, tracheostomy care, or even palliative care. This program provides ICU level care in the comfort of your own home. This keeps families together, improves quality of life, often leads to better outcomes compared to an ICU, cuts the cost of the ICU bed by 50%, and frees up the ICU bed that is in high demand.

So, your next step, Sarah, is do not accept vague answers about danger without specific explanations. Your dad deserves proper monitoring and appropriate imaging to guide his treatment, get all medical records, request a family meeting, and have me present, and we’ll help you navigate this, ask the right questions, advocate for your dad, making sure he gets best care and treatment always.

And check out intensivecareathome.com for home care if that’s what’s needed down the line.

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.

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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.