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Quick Tip for Families in Intensive Care: My Dad is Awake on a Ventilator in the ICU After Stroke, Does He Need a Tracheostomy?

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

So today, I have an email from Jean who says,

“Hi Patrik,

My dad is on a ventilator, fully aware but not able to get off it. Should I do a tracheostomy? He’s also a stroke patient. What should I do?” That’s a great question.

So, the first question is, why can’t he get off the ventilator? Is it simply that he can’t get off the ventilator because he’s not strong enough? Because he’s still on too much sedation? Because he’s not getting mobilized because they’re not doing everything within their power to get him off the ventilator? Those are the first questions you need to ask. What is it they’re not telling you what questions haven’t you asked?

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.

When we look at medical records when we talk to doctors and nurses directly and ask the questions that you haven’t even considered asking but must be asked, then we will often find they’re not doing everything within their power to definitely get patients off the ventilator because it’s complacency, it’s laziness, it’s simply sometimes lack of staff because there’s not enough ICU nurses, not enough ICU doctors and et cetera to get patients off the ventilator. So, those are the first types of questions you need to ask.

So then, the question is this, with a stroke, your dad might be able to get off the ventilator eventually if he has a tracheostomy, but then he might need the tracheostomy because he might not be able to swallow properly because of the stroke. These are all questions you need to ask the intensive care team.

Some of the questions you need to ask, I have also written a blog post and made a video, “How to wean a critically ill patient off the breathing tube?” You should be looking at that video or read the blog so that you understand what they need to do to get your dad off the ventilator.

Then if, God forbid, he does need a tracheostomy, once again, the goal is to get him off the ventilator as quickly as possible, get him off the tracheostomy as quickly as possible, whether that’s possible or not. You haven’t shared enough information with me.

How much FiO2 (fraction of inspired oxygen) is it on? How much PEEP (positive end-expiratory pressure) is he on? Is he already doing spontaneous breathing trials? Once again, is he sedated still? Does he have opiates such as morphine, fentanyl, which by the way, have respiratory depression as a side effect? So, you really need to get into the nitty-gritty to find the answers here.

Then if, God forbid, your dad can’t come off the ventilator at all, then there are services like Intensive Care at Home, and you can find more information at intensivecareathome.com..

For example, if patients are stuck in the ICU with a ventilator and the tracheostomy can’t come off it, go and seek out intensivecareathome.com. Even if your dad, God forbid, ends up with a tracheostomy and doesn’t need a ventilator, again, he can go home with services like Intensive Care at Home. Again, for more information, go to intensivecareathome.com.

I hope that helps.

Now, we have a membership for families of critically ill patients in intensive care that you can become a member of, and you can become a member at intensivecarehotline.com by clicking on the membership link or by going to intensivecaresupport.org directly. In the membership, we answer all questions intensive care related and you have access to me and my team there, 24 hours a day, in the membership area and via email.

I also offer one-on-one consulting advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to doctors and nurses directly and ask all the questions that you haven’t even considered asking but must be asked so that you can make informed decisions, and have peace of mind, control, power, and influence.

I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over five years. I’ve been consulting and advocating for families in intensive care for over 10 years here at intensivecarehotline.com and you can check out our testimonial section, what results we are getting, and what we have been getting for our clients.

I also represent you in family meetings with intensive care teams. First of all, I also strategize with you whether we should even go into a family meeting with intensive care teams. Just because intensive care teams say, “Well, you should be there tomorrow at three o’clock for a family meeting”, doesn’t mean you should be going, but just because they say jump doesn’t mean you should be asking how high. You need to have a strategy.

99% of families in intensive care have no strategies and that opens all doors for manipulation from the intensive care team. They’re not necessarily telling you what is accurate. They’re withholding information, and I can help you with getting that second opinion that you need to make informed decisions, and have peace of mind, control, power, and influence.

Also, we offer medical record reviews in real-time so that, once again, you can have 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 simply suspecting medical negligence.

All of this, you get at intensivecarehotline.com. Contact us on one of the numbers on the top of our website or send us an email to [email protected].

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 or what questions and insights you have, and share the video with your friends and families.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.