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Quick Tip for Families in Intensive Care: Brother had Heart Attack & Anoxic Brain Injury. What Does it Mean When ICU Pushes to Make “Decisions?”

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today, I have an email from John who says, “My brother had a heart attack and he’s now in ICU. He has a severe anoxic brain injury and he’s on life support. The ICU team is pressuring us to make some decisions, but I feel like I don’t understand the implications.” Well, that is a great question and it’s something that we see all the time.

We get calls from families and say, “Oh, ICU says we need to make a decision tomorrow at 3:00, we need to have made a decision.” My response to that is, if the ICU team asks you to jump off a bridge tomorrow at 3:00, would you jump off a bridge tomorrow at 3:00? I’m sure you’ve got the answer to that. So, why would you give in to making decisions that you don’t know anything about? That’s the problem.

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, and that is exactly the dilemma that John has here. Bear in mind, this is a life-or-death decision, most likely. So, why would you be pressured into a life-or-death decision?

Now, there are situations when you need to make a quick decision; however, if your brother is on life support, he had a heart attack, he has potentially a severe anoxic brain injury, let me tell you what needs to happen first before you jump to any conclusions, before you make any decisions. So, he’s on life support that means he’s alive with support, that in and of itself often buys time to make decisions. That’s number 1.

If he supposedly has an anoxic brain injury, how is that verified? Has he had a CT scan of the brain? An MRI scan of the brain? EEG of the brain? Is your brother potentially still on sedatives and opiates? That would keep him asleep, maybe that’s why he’s not waking up. Or is he off sedation? If he does have an anoxic brain injury, maybe that is why he’s not waking up.

We got to find out what else is happening. What are his ventilator settings? What are the blood results? What medications is he on? What is the cardiologist saying about his heart attack? Does his heart need ongoing support, ongoing maintenance? Does he potentially need cardiac surgery? Has he had an angiogram or an angioplasty?

What is the neurologist saying about the outlook with an anoxic brain injury? Does he potentially need a tracheostomy? Can he be weaned off the ventilator without needing a tracheostomy? Will he need a tracheostomy but not ventilation? There are all these questions.

The only urgency that I can see here that you might have to make a decision at some point is depending on how long your brother has been in ICU for on a ventilator, that after about Day 10 to Day 14 of mechanical ventilation and the breathing tube, and the inability of your brother coming off the ventilator that he might need a tracheostomy, but you haven’t given any timelines.

Even if the time is up and you should look into whether he needs a tracheostomy or not, the first question that you should be asking is, “Have they done everything beyond the shadow of a doubt to wean your brother off the ventilator and avoid the tracheostomy?” That must be your first question. You can answer that question by looking at another one of my blog posts where I explained, “How to wean a critically ill patient of the ventilator and the breathing tube?” I would do that. I would encourage you to do that. I’ll put the link below this video to that blog post.

So, don’t be pressured, get a second opinion. We can give you a second opinion here. We can look at the medical records. We can talk to the doctors and nurses because I will ask all the questions to the doctors and nurses that you haven’t even considered asking but must be asked in a situation like that so that you can make informed decisions, have peace of mind, control, power, and influence.  It’s inevitable to get to that point, which I believe you’re not at that point.

So, if you want your questions answered for your loved one in intensive care, we have a membership for families of critically ill patients in intensive care. You can get access to that membership at 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. We give you step-by-step advice, we review medical records, and help you understand what’s happening, give you proven strategies.

I also offer one-on-one consulting and advocacy over the phone via Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talked to doctors and nurses directly. Once again, I ask all the questions that you haven’t even considered asking but must be asked so that you make informed decisions, have peace of mind, control, power, and influence.

Now, I have worked in critical care/intensive care for over 20 years in three different countries where I also worked as a nurse manager for over 5 years in intensive care. I have been consulting and advocating for families in intensive care all around the world at intensivecarehotline.com since 2013, I can say without any shadow of a doubt that we have saved lives with our consulting and advocacy.

It’s as simple as that and you can verify that on our testimonial section as well as some podcast interviews on our website at intensivecarehotline.com.

We also offer medical record reviews in real time so that you can make informed decisions, have peace of mind, control, power, and influence in real time and that you can get simply a second opinion. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

I also represent you in family meetings with intensive care teams so that you have an advocate there that can advocate for your interests.

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 [email protected].

If you like my video, 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.

Thanks for watching.

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

Take care for now.