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Quick Tip for Families in Intensive Care: Dad had a Cardiac Arrest Three Days Ago, 20 Min CPR (Cardiopulmonary Resuscitation), the ICU Team is Negative, Help!

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

So, today’s tip is a question from Aaron, who says,

“Hi Patrik,

My dad had a sudden cardiac arrest at an airport. Bystanders rushed to perform CPR (Cardiopulmonary resuscitation) within 2 to 3 minutes, my mom said. The paramedics got there and performed CPR for a little over 20 minutes before my dad was going to hospital. He coded again in the ambulance. He has been sedated with a breathing tube for 3 days now and had an original CAT (Computerized Axial Tomography) scan and said there was no severe damage but the EEG (Electroencephalogram) came back as showing not a lot of activity. He’s going to have an MRI (Magnetic Resonance Imaging) today. The doctors don’t seem very optimistic about him. Please help.”

Aaron, I’m very sorry to hear about your dad’s situation. Three days in the ICU is not a long time, that’s the first thing. If the EEG came back showing not a lot of activity, that might be due to him having brain damage. It might also be due to him being heavily sedated and on opiates. If the CT scan didn’t show any damage, that’s good. But obviously, the MRI scan will be more conclusive. There’s no question about that.

But the other question that you need to ask is, was he in cooling therapy, for example, in the last few days? If he was in cooling therapy, he might have been paralyzed, like chemically paralyzed with paralyzing agents so that he can’t move. How much sedation was he on while he was paralyzed, potentially if he was in cooling therapy? Most patients after cardiac arrests are in cooling therapy.

It’s going to be a waiting game in terms of what the MRI shows. It’s going to be a waiting game also, for you to think about what you would like for your dad? Do you want him to come out of this? Do you not want him to come out of this? Will he have any quality of life?  If his quality of life is potentially being poor, what does that mean for you and your family? Would you accept that? Would he accept that? So, there are a lot of questions that need to be answered, and they can only be answered over time.

In terms of will your dad wake up? Can he improve? What does neurology say about his prognosis? Is it likely to happen again, him having a cardiac arrest? What was the cause of the cardiac arrest? What is cardiology saying? Did he have an angiogram after the cardiac arrest to find out whether there were any cardiac blockages? So, there’s a number of things that need to be answered.

Is he stable at the moment? Is he on inotropes? Is he on vasopressors? Is he on vasodilators? Is he in an irregular heart rhythm at the moment, which can happen after cardiac arrest. For example, he is in AF (Atrial Fibrillation) or A-fib? Those are all questions that need to be answered before you’re jumping to any conclusions here, you got to give it some time.

Here is what’s important to know. Sometimes patients are in an induced coma, and they don’t have any brain damage, and they’re not waking up quickly. Your dad might have had brain damage or might have brain damage, and he may also not wake up quickly, but it has to be determined. What is the cause of him not waking up and also, how long will it take for him to wake up? Will it be days? Will it be weeks? Will it be months? Can you ever wake up? But to jump to conclusions after three days is way too early.

Now, if the intensive care team is negative and pessimistic, to a degree, you got to brush that off because once again, three days in ICU is not a long time. That’s number one.

Number two, you have to see what comes in the next few days, and potentially in the next few weeks, you need to make decisions today that you don’t regret in 12 months’ time. For example, if you let your dad pass away today because you agreed to potentially let them stop life support. You will probably regret that in 12 months’ time, and you never find out the what if questions. What if you had continued with supporting him?

The other thing that you have to keep in mind is that a lot of patients after cardiac arrest that don’t wake up as quickly as intensive care teams want them to wake up is that they present the worst-case scenario for an intensive care team.

So, what do I mean by that? The worst-case scenario from my experience of having worked in intensive care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years, and I’ve been consulting and advocating for families in intensive care all around the world since 2013 here at intensivecarehotline.com, is the biggest challenge for intensive care is that they’re going to look after a patient with an uncertain outcome indefinitely, and your dad might present that scenario to them. Nobody knows at the moment but to throw in the towel would be way too early. The doctors can’t just withdraw treatment without your consent.

Make sure that you understand that end of life care decision making does not happen in a vacuum. It happens around laws and policies and procedures, so it does not happen in a vacuum. So, keep that in mind.

Make sure that you inform yourself about your rights so that you don’t need to rush into a decision here. You don’t need to rush into a decision. Give you time to see how your dad shows up in the next few days and potentially in the next few weeks. There’s no rush in ending someone’s life. That’s always the question you need to ask, “What’s the hurry in potentially ending someone’s life?” There is no rush.

So, that is my quick tip for today.

Because we get so many questions from families in intensive care, that’s why we created a membership for families of critically ill patients in intensive care at intensivecarehotline.com and you can become a member if you go to intensivecarehotline.com and you click on the membership link or 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, making sure you make informed decisions, you have peace of mind, control, power, and influence.

In the membership, you also have access to 21 videos, 21 e-books that I have personally written helping you to navigate this incredibly difficult territory that is intensive care. These e-books and videos will help you to make informed decisions, have peace of mind, control, power, and influence, making sure you get best care and treatment for your loved one.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly. Once again, I ask all the questions to the doctors and nurses that you haven’t even considered asking but must be asked when you have a loved one in intensive care. I also make sure that you ask the right questions when you talk to doctors and nurses directly.

I also represent you in family meetings with intensive care teams, once again, making sure you make informed decisions with peace of mind, control, and influence, and furthermore, that your loved one gets the best care and treatment.

We also offer medical record reviews in real time so that you can get a second opinion in real time. 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.

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].

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

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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