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Quick Tip for Families in Intensive Care: Deciding for My Ventilated Mother in ICU Between Weaning, Extubation, or Tracheostomy, Can You Explain?

If you want to know the difference between weaning, extubation, or tracheostomy, stay tuned. I will explain it for you today.

My name is Patrik Hutzel from intensivecarehotline.com and I have another quick tip for families in intensive care today.

I have an email from Renee who says, “We want to decide for my mother whether we should wean her off the ventilator, extubation, or do a tracheostomy?”

Now, as I’ve been saying for over a decade now, 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, and that is exactly what Renee is up against here.

So, let’s break down some terminology today. Again, the email says, “We need to decide for my mother in intensive care on a ventilator with a breathing tube, whether we are doing weaning, extubation, or tracheostomy.”

Let’s start with extubation. What does extubation mean? Extubation means to remove a breathing tube  and let someone breathe spontaneously when they are ready and avoid the tracheostomy altogether and that should always be the goal when someone is in intensive care on a ventilator with a breathing tube, full stop.  There’s one exception with extubation, which is a one-way extubation for end-of-life care, but that is not what Renee is talking about here.

So, let’s look at the terminology weaning off a ventilator. Well, what does weaning off a ventilator mean? It means that when a patient is on a breathing tube in intensive care on a ventilator to wean them off slowly, sometimes slowly, sometimes faster. Again, with the goal to extubate them eventually. Again, extubation means the removal of a breathing tube, and that once again should always be the goal in order to avoid the tracheostomy, full stop.

So then, let’s look at the last term, which is tracheostomy, do a tracheostomy. So, tracheostomy is basically a breathing tube that goes through the neck, so that the breathing tube in the mouth can be replaced. Why is that? Well, that is generally speaking the case if someone can’t be weaned off the ventilator, and that hopefully should be temporarily. So, if someone has been ventilated for 10 to 14 days in intensive care with a breathing tube, and they can’t be weaned. They can’t be weaned beyond the shadow of a doubt but that is also very important.

How can you determine whether they can’t be weaned off the ventilator beyond the shadow of a doubt? Well, in a nutshell, you have to ask the right questions. Once again, that’s where I keep saying, the biggest challenge for families in intensive care is that they don’t know what they don’t know. You’re going to know what to look for. You’re going to know what questions to ask. So, how do you know that they are trying to avoid the tracheostomy beyond the shadow of a doubt? How do you know they’re trying to wean your critically ill loved one off the breathing tube and the ventilator so that a tracheostomy can be avoided?

Well, I’ve made a video about that. The title, “How to wean a critically ill patient off the breathing tube and the ventilator?”, and I will link towards that video and blog post in the written version of this video blog, so you can look it up.

So, if a tracheostomy needs to be done after day 10 to 14 of mechanical ventilation with a breathing tube, then that is probably the right thing to do. But most importantly, the intensive care team should have made all efforts to wean your mom off the breathing tube and the ventilator and that needs to happen with physical therapy, physiotherapy, mobilization, breathing exercises, taking away all sedation, taking away all opiates. That’s how that is, generally speaking, done.

So, I hope I clarified the terminology today because after having worked in critical care nursing in 3 different countries, where I worked as a nurse manager in critical care for over 5 years, and where I’ve been consulting and advocating for families in intensive care all over the world since 2013 here at intensivecarehotline.com, it is clear that families in intensive care need to be clear on the terminology. They hear terms and they don’t really know what that means, which is, on the one hand, it’s good, that’s what I’m here for, so I can break down the terminology for you. But it is also very confusing, and you could be making the wrong decision for your critically ill loved one because you don’t understand what’s really happening.

With intensivecarehotline.com, I can very confidently say that we have saved many lives with our consulting and advocacy, and you can verify that on our testimonial section so you can see that I’m not exaggerating the slightest. You can verify that also on our podcast section at intensivecarehotline.com where we have done client interviews.

So, coming back to Renee’s email, what should Renee be deciding here? Well, biggest decision you should be making here is to ask the intensive care team and hold them accountable that they wean your mom off the ventilator and the breathing tube beyond the shadow of a doubt.

Now, one thing that you haven’t shared is, why is your mom in ICU? You haven’t shared any of that, which would also be important to know. Why is she on a ventilator with a breathing tube? Why are they trying to wean her off? Why are they trying to extubate her? Why are they trying to do a tracheostomy?

With all these terms to a degree contradict each other because once you extubate the patient, you don’t need a tracheostomy. Once you wean a patient, especially on a breathing tube, you won’t need a tracheostomy. You might also wean a patient on a tracheostomy, of course, but she’s not there yet. Like I said, ideally, she can avoid the tracheostomy, so.

Like I said, we’ve been consulting and advocating here at intensivecarehotline.com for families in intensive care all around the world since 2013. Like I said, I can very confidently say, that we have saved many lives with our consulting and advocacy. Once again, check out our testimonial section at intensivecarehotline.com to verify that or check out our podcast section at intensivecarehotline.com where we’ve done client interviews.

I can once again, without the shadow of a doubt, say that our advice here at intensivecarehotline.com is absolutely life changing. It’s a game changer because your biggest challenge is that you don’t know what you don’t know. You don’t know what to look for. You don’t know what questions to ask. You don’t know your rights, and you don’t know how to manage doctors and nurses in intensive care, clearly.

That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, 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. You can join a growing number of members and clients that we have helped over the years, hundreds, if not thousands of members and clients we have helped over the years to improve their lives instantly and to improve the lives of their family members in intensive care instantly and that’s also why I talk to doctors and nurses directly. When I talk to doctors and nurses directly. I ask 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. When I talk to doctors and nurses directly, I hold them accountable, something you can’t do because you don’t know what questions to ask, and you will see that the dynamics will change in your favor very, very fast. 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 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 at intensivecarehotline.com. 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 get 21 e-books and 21 videos that I’ve personally written and recorded so that you 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, 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 a show. You will get notification for the YouTube live if you’re a subscriber to my YouTube channel or if you’re a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com and share this video with your friends and families.

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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