Quick Tip for Families in Intensive Care: My Dad’s in ICU in an Induced Coma Ventilated & with a Breathing Tube, He’s Opened his Eyes but Isn’t Waking Up!

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

Today, I have an email from Penny who says,

“Hi Patrik,

My dad has been in an induced coma now for 1 week. They woke him up before three times and he responded. The last time he opened his eyes but didn’t respond. I’m so extremely worried. It seems like the longer they are sedating him, the more difficult it gets. I am heartbroken but thank you for your video. It’s a little comforting. Can you help?” All right, Penny. Thank you so much for writing in.

You are probably right in saying that the longer you keep someone sedated, the more difficult it gets. You are probably very correct in saying that.

So here is what often happens. Trying to wake someone up after an induced coma and you haven’t specified why your dad is in an induced coma, but let’s just say he’s got a pneumonia, and they’ve cleared the pneumonia and now they want to wake him up. He’s breathing more spontaneously or they’re trying to get him to breathe more spontaneously. Now, they’re waking him up. Then, they wake him up and he’s opening his eyes, he’s responding but then he also gets a little agitated or gets a little combative even sometimes.

So, then you can see that patients can’t follow instructions how to wean them off the ventilator. Then you have to put them back in an induced coma again, and maybe this time around they’re using something else. Maybe this time around they’re using midazolam/Versed instead of propofol. Then they’re going into an even deeper sleep, generally speaking, and it takes longer for them to come out of an induced coma.

So, yes, it is a vicious cycle and sometimes there’s a lot of trial and error before someone gets out of an induced coma safely. It’s more of an art rather than a science depending on how different patients respond to different sedatives. On top of the sedatives, patients are also often on fentanyl and morphine, which are opiates to control the pain when patients are having a breathing tube in their throat.

So, you are worried and rightly so because the longer he’s sedated, like I said, the higher chances he won’t wake up, the higher chances he won’t come off the ventilator, the higher chances he needs a tracheostomy, for example.

So, but a lot of it comes down to what are they doing? How skilled are they in weaning patients off the ventilator? I’ll give you an example. A lot of ICUs are running on a lot of junior staff and if they’re running on a lot of junior staff, that also means, they don’t have as many skills as an ICU where there’s lots of senior staff, whether it’s doctors or nurses. So, a lot of it comes down to that as well to the skill level that an ICU can offer or has on the ground, so to speak.

Now, let’s just say he’s not coming around after they take him off sedation completely which may also happen eventually. Then they need to do neurological tests, they then need to do a CT (Computed Tomography) scan of the brain, an MRI (Magnetic Resonance Imaging) scan of the brain, an EEG (Electroencephalography). So, they need to do all of that. They need to do all of that in order to ascertain whether there’s some neurological damage, God forbid.

But most importantly, I have written an article, “How to wean a critically ill patient off the ventilator and the breathing tube?” and whilst you’re not spelling that out in your email, that’s in essence what it is. It is to successfully wean a patient off the breathing tube and the ventilator. That’s what it is to get someone out of an induced coma.

So be patient, but also, they need to be persistent, and they need to find the right mixture of sedatives and try and wake him up so that he can be talked through weaning off the ventilator so that he can obey commands and open up that window of opportunity where he can be safely taken off the ventilator. So, I hope that helps and I hope that explains.

I’ve worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I probably looked after thousands of critically ill patients and their families in my lifetime. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com.

I can confidently say we have saved many lives for our clients and their families. You can verify that on our testimonial section, or you can verify it on our podcast section where we’ve done some client interviews.

That’s why we created a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, click on the membership link or 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 e-books and 21 videos that I’ve personally written and recorded that will help you to make informed decisions, have peace of mind control, power, influence, making sure your loved one gets best care and treatment and so that you can influence decision making fast when you have a loved one critically ill in intensive care.

That’s also why I offer one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I talk to you, and I handhold you and your families through this once in a lifetime situation that you simply can’t afford to get wrong. I 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 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.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or 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.

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