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Quick Tip for Families in Intensive Care: Dad’s in ICU with Pneumonia, Sepsis, Seizures, Potential Brain Injury, How Long Does It Take to Wake Up?

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

Today, I have an email from Ellis who says,

“Hi Patrik,

No luck in waking my dad up. His pupils are still not reacting. He’s never had a seizure before. His liver isn’t doing great and recently he had a pneumonia and sepsis, but he seems to be a bit better.

Now, we’re hoping to get him back to the U.K. He’s currently in an ICU in Spain. The language barrier is hard. They said they can’t tell if there is any brain damage until he’s awake. I’m scared he won’t wake up; I think he needs a lot of time though due to being on such high sedative medications. He’s now on lacosamide, lorazepam and CBD (cannabidiol) oil. What are the chances of him waking up?”

Ellis, thank you so much for writing in. You’re giving me bits and pieces here but there seems to be quite a few ingredients missing or quite a few critical ingredients missing to paint the picture.

Like I’ve been saying for a very long time, 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 an even bigger challenge now that you’re in Spain and there’s a language barrier, and you need to get your dad back to the U.K.

Now, if he’s never had a seizure before, chances are there is some sort of brain damage. I strongly, strongly disagree that they can’t tell if he has any brain damage because they could do a CT (Computed Tomography) scan of the brain, they could do an MRI (Magnetic Resonance Imaging) scan of the brain, they could do an EEG (Electroencephalography), and they could do a neurology referral. All of that they should be doing.

So, if he’s on high sedative medications like lacosamide, lorazepam and CBD oil, yes, it might take him a while to wake up. But given that he’s got pneumonia and sepsis, he probably also has a lot of issues to deal with that need to be cleared first i.e. if he’s got a pneumonia, what type of pneumonia? Is it a bacterial pneumonia? Is it a viral pneumonia? Is it a fungal pneumonia? If it is bacterial, are they giving him antibiotics? If it is viral, are they giving him antivirals? If it is fungal, are they giving him antifungals? Once the pneumonia is cleared, then steps should be taken to wean your dad off the ventilator.

You’re saying he also has a sepsis which might be secondary to the pneumonia. Well, if he’s got a sepsis, what should they be doing? If he’s got a sepsis, you should be looking at giving him, again, antibiotics, antivirals, antifungals depending on where the sepsis originates from. Have they done the sputum sample? Have they done the urine culture? Have they done the blood culture to find out where the sepsis is?  If he’s got sepsis, he’s probably on inotropes or vasopressors because his blood pressure would be compromised. It would be low, probably almost to a point where it’s not compatible with life or where it might cause organ failure. That’s why he probably needs the vasopressors and the inotropes.

So, he’s probably not quite in a position where he can go back to the U.K. now even though it’s possible to fly critically ill patients around the world, it’s better when patients are stable. I don’t know how ICUs in Spain operate, whether there are any translators, I wouldn’t know but the next steps are to stabilize him with what I just mentioned and then get him back to the U.K. But there’s nothing stopping them from doing a CT scan, MRI scan of the brain, or an EEG. There should be absolutely nothing stopping them.

Also, if he’s not waking up, another consideration here is, should he be having a tracheostomy before going back to the UK? You haven’t shared how many days it’s been since your dad’s been in ICU. Those are all considerations for you to take into account. How many days has he been in ICU for? If he’s not waking up, if it’s more than 10 days, would it be safer to do a tracheostomy and then fly him back to the UK?

A lot of things that need to be considered here, Ellis. But as always, I strongly recommend you get access to the medical records as quickly as possible. You get a translator involved and you get an advocate like myself where I can talk to doctors and nurses directly and ask all the right questions and the questions that you haven’t even considered asking because there are so many knowledge gaps here in your email.

So, I hope that helps.

I’ve worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can confidently say that we have saved many lives with our consulting and advocacy here at intensivecarehotline.com. You can verify that by looking on our testimonial section at intensivecarehotline.com and you can also verify it by looking at our podcast section at intensivecarehotline.com where we’ve done client interviews.

That’s why we have created 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. There you can join the membership where 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. With all of that access to me and the additional resources, you can make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment so that you can influence decision making fast.

So, join us in the membership where we have helped hundreds of members and their families, helping them, saving their lives, getting better outcomes, and showing families how to manage intensive care teams so they don’t manage you.

I also do one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly. I represent you in family meetings with intensive care teams. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. When I talk to doctors and nurses directly, I will ask all the questions that you simply haven’t considered asking that I can ask with my 2.5 decades worth of intensive care nursing experience.

We also do 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 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 [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.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

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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