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Quick Tip for Families in Intensive Care: My 45-Year-Old Wife Had Cardiac Arrest 3 Weeks Ago in ICU, Ventilated & Tracheostomy, Not Waking Up!

If you want to know whether sedation when having a tracheostomy is necessary, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So yesterday, I was talking to a client who said that his 45-year-old wife is in ICU. She had a cardiac arrest around two and a half weeks ago, had some CPR (Cardiopulmonary Resuscitation), ended up in ICU ventilated with a breathing tube, had a CT (Computed Tomography) scan of the brain and MRI (Magnetic Resonance Imaging) scan of the brain which all showed there’s no brain damage, but she wasn’t waking up or only waking up very slowly. She also had an irregular heartbeat, probably because of the cardiac arrest. Eventually, she ended up with the tracheostomy because she couldn’t be weaned off the ventilator with the breathing tube. So, she had a tracheostomy after about two weeks.

Now he’s saying that his wife still doesn’t wake up because he thinks there’s just a delay and then I asked him, “Well, is she still on sedation?” And then it turns out that she’s still on sedation.

I asked him, “Has she had physical therapy?” He said, “No.”

I asked him, “Has she been mobilized?” And he said, “No.”

Well, here’s the news. Whenever patients have a tracheostomy, one of the main reasons they’re having a tracheostomy is to switch off sedation. By switching off sedation, patients can wake up. When patients are having a breathing tube in their throat, it’s very difficult for that breathing tube to tolerate, it’s very painful, it’s very uncomfortable. That’s why patients are often induced into an induced coma having propofol, Midazolam/Versed, and/or morphine or fentanyl, and sometimes Precedex.

So, when someone shows they can’t be weaned off the ventilator beyond the shadow of a doubt, then the tracheostomy is the right next step, I have made countless videos about that. But then, one of the main advantages of having a tracheostomy is that it’s much easier to tolerate and therefore, sedation is not necessary.

So, I recommend it to the client that (a) he should get access to the medical records as quickly as possible so we can have a closer look on what’s really going on, and (b) he should ask for sedation to be stopped so that his wife can wake up, and that physical therapy or physiotherapy, as well as mobilization, can be commenced, and that’s how you wean someone off a ventilator.

Now, after cardiac arrest, patients sometimes need a long time to wake up. It’s the nature of the beast and patients just simply need time to rest and heal, there’s nothing wrong with that. But by having sedation on whilst having a tracheostomy, there’s no need for that 9 times out of 10. There’s absolutely no need for it unless someone is fighting against the ventilator, is having surgery, or things like that. Not starting physical therapy is also not appropriate, physical therapy should be started as soon as possible. Mobilization should be started as soon as possible.

The only reason why patients can’t be mobilized is really, if they’re having fractures, if they are hemodynamically unstable i.e. their blood pressure is too high, too low, if their heart rate is too high, too low, irregular, those are usually contraindications for mobilization of physical therapy. But if that’s not present, then you can start physical therapy, you can start mobilization, you can start weaning off the ventilator, all of that.

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 exactly what our client is dealing with here, but I know we can help you help him with all of that, working through the next steps making sure his wife will improve from that.

Now, I have worked in critical care for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years and where I also have been consulting and advocating for families in intensive care all around the world since 2013. I can confidently say that we have saved many lives for families in intensive care with our consulting and advocacy. You can verify that at our testimonial section at intensivecarehotline.com or you can verify it on our podcast section at intensivecarehotline.com where we have done some client interviews.

Also, we have created a membership for families of critically ill patients in intensive care because we get so many questions, and you can become a member for the membership 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 as it relates to families and their loved ones.

In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded sharing all my decades worth of experience in intensive care nursing, helping you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment.

I also do one-on-one consulting and advocacy for families in intensive care. I talk to you and your families directly over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you.  I talk to you and your families directly. I handhold you through this process making sure you are two steps ahead of the intensive care team so that you are managing intensive care teams and not the other way around. Once again, all with the goal of you making informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment. I also talk to doctors and nurses directly and 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.

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 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 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, and share the video with your friends and families.

Also, if you want to make a small donation, click the super chat button. If you want a video done for your situation, give us a small donation. I will record a video because our questions are going back as far as October last year. So, I’m still catching up with all the questions that we’re getting every day and making videos about that.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for that if you subscribe to my YouTube channel, or if you are a subscriber to our 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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