Quick Tip for Families in Intensive Care: How to Delay a PEG (Percutaneous Endoscopic Gastrostomy) Tube
in ICU After Stroke & What Families Must Know!

My name is Patrik Hutzel from intensivecarehotline.com, where 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 the best care and treatment, even if you’re not a doctor or a nurse in intensive care.

So, today’s quick tip for families in intensive care is about this question: “How can the PEG (Percutaneous Endoscopic Gastrostomy) tube be delayed for 6 months in this situation, is the patient on an oral gastric feeding tube?” Now, let’s put this into context.

We’re talking about a 51-year-old man in ICU for 14 days after a hemorrhagic stroke. He’s been ventilated, and the ICU team is already talking about a “one-way extubation.” That’s basically code for end-of-life care without them quoting that, it’s basically a euphemism for, “we’re going to let your loved one die.” And if you don’t know how to read between the lines when you have a family member critically ill in intensive care, the good news is you’ve come to the right place to decipher everything that’s being said and to get help.

So, here’s what you need to know. A PEG or a percutaneous endoscopic gastrostomy is a feeding tube placed directly into the stomach through the abdominal wall. But a PEG tube is not really urgent in the first few weeks or even few months of ICU treatment, feeding can be done through an oral gastric tube, through the mouth into the stomach, or ideally through a nasogastric tube. Through the nose into the stomach. The latter would be the more preferred one, because it is more comfortable than having a tube in your mouth.

Both of those are standard practice in ICU and can be used for weeks or even months, so yes, a PEG can absolutely be delayed for 3 to 6 months or potentially even longer depending on circumstances. While you are waiting to see your loved one’s neurological, how your loved one’s neurological recovery is going to unfold. Because what that means is, if your loved one is ending up with a PEG tube prematurely, the perception in the medical field and in the nursing field, is that if someone is having a PEG tube, they will never eat and drink again. So, people will stop even trying to get that patient back on oral feeds. Now, the perception in the medical field and the nursing field about a nasogastric tube or an oral gastric tube is, it’s temporary, and people will eat and drink again, and therefore, you must try to get that patient back on an oral diet. Big perceptional shift. And I know which one that I would want for me or for my family member.

So, the right questions to ask in ICU in these situations are: Is my loved one currently fed through an orogastric tube or a nasogastric tube? What’s the rush for a PEG tube after only 2 weeks? Can we delay the PEG for at least 6 months until swallowing is properly assessed? Why hasn’t a tracheostomy been offered instead of a one-way extubation?

Cause that’s another thing that families often don’t find out or they find it out too late, that if ICU is offering a one-way extubation and basically giving you the euphemism about, “Well, we let your loved one die because we don’t really care, because we just need the ICU bed. And we just need to manage our finances and resources.” Tracheostomy is a life-prolonging device. And I’ve extensively written and made videos about this, so I’m not going into too much detail now because today’s topic is about a PEG tube or not doing a PEG tube.

So it’s a much bigger issue because a one-way extubation is essentially the ICU saying, we’re not  giving your loved one a chance, and that is unacceptable when the patient is still breathing spontaneously, tolerating minimal ventilator settings and simply needs more time to either be extubated so that they can breathe independently and live, or if they can’t be extubated for whatever reason, to do a tracheostomy, the PEG can wait. What your loved one really needs now is time, tracheostomy and eventually specialist neurorehabilitation.

So don’t let ICU teams corner you into rusty rushed decisions, slow things down. Ask the right questions, advocate for your loved one, and we are here by your side doing the advocacy for you. Because if you are in a situation right now and you don’t know what to do next, go to intensivecarehotline.com, and contact me directly. Call me on one of the numbers on the top of our website at intensivecarehotline.com.

I talk to families and ICU teams every day, asking the right questions you haven’t even considered asking. But must be asked. I represent you in family meetings, review medical records in real time with my team, and make sure your loved one gets every chance of survival and recovery because we have saved so many lives at intensivecarehotline.com and you can verify that on our testimonial section as well as on our intensivecarehotline.com podcast section where we’ve done client interviews.

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 for our clients in intensive care. You can verify that on our intensivecarehotline.com testimonial section and also on our intensivecarehotline.com podcast section where we have done client interviews.

Because our advice is absolutely life changing, it is absolutely life changing. That’s why you can join a growing number of members and clients that we’re helping in intensive care. We’re improving their lives instantly, making sure families in intensive care can make informed decisions, have peace of mind, control, power and influence, making sure their loved ones get best care and treatment always.

Because 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 is exactly what you’re up against.

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. When I talk to doctors and nurses directly, which I do as well, you would see the dynamics change in your favor very quickly because you have someone on your team that understands intensive care inside out.

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. 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 that only our members have access to.

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.

Related Articles:

Quick Tip for Families in Intensive Care: When’s a Pt a Candidate for a Ventilator? What Criteria for a Pt No Longer Needing a Ventilator? Case Study: How to Save your Loved One’s Life in ICU or How to Prevent a “One Way Extubation” Quick Tip for Families in ICU: My 80-Year Old Dad’s in ICU After Heart Attack & Now ICU is Saying He’s in Multi organ Failure! Help! Quick Tip for Families in Intensive Care: How to Treat a Cardiac Arrest in Intensive Care! Quick Tip for Families in Intensive Care: Is it Safe for My Grandma to Go to LTAC After Stroke, Tracheostomy, and Nasogastric Tube?