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Quick Tip for Families in Intensive Care: My Brother’s in ICU on Ventilation for 14 Days. His Blood Gas Exchange Isn’t Well, Can He Get Better?
“My brother is in ICU. He has been on a ventilator for 14 days. His blood gas exchange is not doing well, but everything else is. The ICU team says, we are okay for now. I just don’t want to wait until it’s been too long or too late to help him getting best care and treatment.” From one of our readers, Kate.
My name is Patrik Hutzel from intensivecarehotline.com, and this is another quick tip for families in intensive care.
So, let’s look at Kate’s email in detail. I’m very sorry to hear that your brother is in ICU. Fourteen days on a ventilator is a significant milestone, and your instincts are right to stay proactive and protective of your brother.
When someone like your brother remains ventilated that long and arterial blood gas exchange is poor, the medical team usually starts discussing longer-term options like a tracheostomy to avoid ventilator-associated complications and make weaning more manageable. But before you’re even looking at weaning or to do a tracheostomy, you really need to find out if the ICU team is doing everything beyond the shadow of a doubt to avoid the tracheostomy and wean your brother off the ventilator and the breathing tube.
So, I have done a video and a blog post about, “How to wean a critically ill patient off the breathing tube and the ventilator”. I will link to that video and blog post in the written version of this blog because that is what you need to look at as well.
Now, in the meantime, here are a few things you can do now to protect the brother’s chances to get best care and treatment.
Number one, ask about the treatment plan. Request a clear treatment care plan from the ICU team. What’s the plan if his arterial blood gases are not improving in the next few days? Has a tracheostomy being considered? Is your brother off all sedation? Is he off all opiates? Because if he’s not, that might be what stops him from getting off the ventilator. Is his brain intact? For example, God forbid, has he had a stroke or any other neurological event? Is that potentially why he can’t come off the ventilator?
Next, pulmonary and critical care consults. Ensure a pulmonologist or respiratory physician is involved, if not already. They can evaluate why gas exchange is still impaired and whether lung protective strategies are being used. Like I said, what else is happening? Is your brother still sedated and on opiates, potentially even chemically paralyzed?
Next, ask whether he’s a candidate for the tracheostomy again, if progress remains slow but stable.
Next, imaging and pathology, and labs. Review any recent chest X-rays, CT (Computed Tomography) scans, or arterial blood gases to understand the nature of the gas exchange problem, i.e. is it from pneumonia, ARDS (acute respiratory distress syndrome), fluid, or potentially scarring?
What do I always say? 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 you’re up against here, Kate.
The other thing that you urgently need to do is get access to all medical record because you need to request a second opinion, which we can give you here at intensivecarehotline.com. We can review the chart remotely. We can tell you pretty quickly if they’re doing everything beyond the shadow of a doubt to get your brother off the ventilator and the breathing tube. Very important.
I hope that helps you understand what needs to happen next.
If you’re struggling with implementing all of what I’ve shared with you now, we also offer consulting and advocacy. I do one on one consulting and advocacy as well.
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 critical 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 if you go to our intensivecarehotline.com testimonial section at intensivecarehotline.com or if you go to intensivecarehotline.com podcast section where we have done client interviews. When you read the testimonials or you watch the podcast with our clients, you will recognize that our advice is absolutely life changing. It’s absolutely life changing.
You can join a growing number of members and clients that we have helped over the years to improve their lives instantly, making sure they make informed decisions, have peace of mind, control, power, and influence, making sure their loved ones get best care and treatment always.
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 can’t afford to get wrong. I make sure you ask the right questions. I make sure you understand everything that’s happening with your critically ill loved one so that you can ask the right questions and get the right outcomes. I also talk to doctors and nurses directly on your behalf or with you or I set you up with the right questions. I’ll make sure 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 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 videos and 21 e-books that only are exclusively accessible to our members. All of that will help you to 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.
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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 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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