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Quick Tip for Families in Intensive Care: My Mother’s Been in ICU for 6 Weeks in an Induced Coma & Breathing Tube, Is It Too Late for a Tracheostomy?

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

So, I want to talk about a client that I was talking to today who said that her mom has been intubated in ICU since the 2nd of November. At the time of me recording this video is the 26th of December so, we’re talking about, 6-7 weeks of intubation and she’s still in an induced coma.

This is another prime example of how I can illustrate 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.

Here’s why I’m saying that. So, she said that her dad who’s also her mother’s power of attorney did not want to give consent to tracheostomy because he thinks she doesn’t need it. But here’s the problem, in the meantime, her mom stays in an induced coma, on propofol. She has been on propofol for many weeks now. In order to tolerate the breathing tube in the meantime, she’s getting deconditioned every day.

Deconditioning when being in an induced coma is real. There’s muscle wastage and that makes it even harder to wean off the ventilator because the breathing muscles are weakened as well.

Now, even 10 years ago, in one of my earlier blog posts, I would have said, “How long can a breathing tube stay in?” Or “When does the tracheostomy need to be done? Well, the breathing tube can stay in for about 10 to 14 days. The tracheostomy should be done by around Day 10 to 14, assuming your loved one can’t come off the ventilator and the breathing tube beyond the shadow of a doubt.

Now, it’s been six or seven weeks, and this poor lady has been in an induced coma, has no chance to wake up. There’s no chance to rehabilitate. So, these scenarios happened during COVID that there was often a delay in tracheostomy simply because of lack of resources. There was a perceived higher infection risk for staff and so forth. There was also high FiO2s, high PEEP, so tracheostomy couldn’t be done. But this is not a COVID situation here. This is an aspiration pneumonia situation.

So, always keep in mind, don’t delay a tracheostomy when appropriate. Don’t use a tracheostomy when not appropriate. Make sure you are holding intensive care teams accountable that they extubate whenever they can. But don’t delay unnecessarily because that damages your loved one further, which is the case here.

So, do your research Day 1 and do it properly and do it thoroughly and get help whenever needed. Keep in mind, you are in a once in a lifetime situation and you can’t afford to get wrong.

Now, the intensive care team can’t force you to give consent to a surgical procedure. But clearly in a situation like that, the family has not done their research and thankfully, they are finally now onto it, better late than never. But making decisions when they need to be made is also very important.

So, that is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

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

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

Once the intensive care team knows that you have someone on your team that understands intensive care inside out, the dynamics will change in your favor. We’ve seen it over and over again and you can look up our testimonials and you can look up some podcasts that I’ve done with some of our clients, verifying what I’m saying here.

Now, 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 5 years, and I have been consulting and advocating for families in intensive care for over 10 years here at intensivecarehotline.com.

Now, I also represent you in family meetings with intensive care teams so that you have clinical representation, that you have counterbalance. But more importantly, they can’t walk all over you in those meetings. More importantly, I assess with you whether you should actually go into a family meeting or not.

Now, we also offer 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 simply suspecting medical negligence and all of that, you get at intensivecarehotline.com.

Now, 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.