“My sister is in an induced coma after a car accident—What should I ask the ICU team?”

My name is Patrik Hutzel from intensivecarehotline.com, where we instantly improve the lives for families of critically ill patients in intensive care, so that you can make informed decisions, have peace of mind, control, power, and influence, making sure your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

So today, I have a question from Roxana, who’s one of our clients who says:

“Hi Patrik,

My sister was hit by a car while riding her bike. She was in a coma that night in one of our local hospitals, and then they transferred her to a metropolitan ICU. She’s now on high sedation. When I asked her to shake my hand for “yes” or do nothing for “no,” she could respond.

She has multiple fractures: Her jaw, one leg, a fractured sternum, and a T6 spine fracture without a spinal cord injury. So far, they’ve done a CT scan and put on leg support for her fracture.

They just keep telling us to wait and see every day. What questions should I ask the ICU team, and can you call them to help us? Thank you.

– Roxana.”

First of all, I appreciate you for being a client and I’m really sorry to hear about your sister’s accident. The good news is that she’s responsive to you, which is a very good sign and it’s very encouraging. The fact that her spinal cord is not affected by the T6 fracture is also positive.

But you’re absolutely right, in situations like this, you must absolutely ask the right questions in ICU to get transparency, understand the treatment plan, and know what’s next, so that you can make sure your sister will get best care and treatment.

So, let’s go through the most important questions you need to ask right now.

1. Neurological and sedation questions

Why is my sister still sedated or in an induced coma? Is she on a ventilator and what are the ventilator settings? Now, as a bonus tip here, I would always take pictures of the ventilator and the monitor and any infusions that are going in. You can share them with us here assuming you’re a client and we will interpret this information for you so that there’s no ambiguity.

2. What did her CT (Computed Tomography) scan of the brain show, MRI (Magnetic Resonance Imaging) scan of the brain show? Did she have an EEG (electroencephalogram)?

When will they start reducing sedation and opiates to assess her neurological function fully? How does she respond when sedation is lightened or off? Can you reduce opiates as well? What sedatives and opiates are she on? Are they long acting? Are they short acting? Are her kidneys and liver working?

Next, let’s look at the fractures and the surgical plan going forward.

What is the plan for her leg fracture? Surgery or conservative treatment? What’s the plan for her jaw and sternum fractures? Again, surgery or conservative treatment? Are all fractures stable? Has the trauma or orthopedic team reviewed her daily?

3. The spinal injury (T6 fracture)

Can you confirm there’s no spinal cord involvement? Is she wearing a spinal brace? What’s the plan for mobilization and physiotherapy once she is more awake?

4. General ICU care questions

Is she breathing on her own or fully ventilator dependent? Is she breathing up more when sedation is lightened and opiates are lightened and reduced? What are her current oxygen levels and vital signs? What are her current arterial blood gases  like? Are there any infections, fevers or abnormal blood results? Are any other organs affected from the trauma like the lungs, liver, or kidneys?

5. Next steps and prognosis

What are the short term and long-term treatment goals? When can sedation be reduced to assess her brain function fully? When do you anticipate she can leave ICU? What’s the plan for rehabilitation?

6. You must get access to the medical records, full stop.

It’s absolutely imperative and non-negotiable that you get access to the medical records because then everything is transparent, and we can check for you, so that what they’re telling you is actually what’s happening in real time. That is really important because what we’re finding over and over again is that intensive care teams are only telling half of the story of what’s going on.

The minute we either talk to them directly, ask questions, or we look at medical records, ideally do a combination of both, we find that what you see is actually not what you get and vice versa, and the stories they’re telling you is very different to actually what’s happening. Now, many families make the mistake of waiting for doctors to volunteer this information that we just discussed, but the truth is they often don’t. You need to lead the conversation.

At intensivecarehotline.com, we can help you do exactly that. We talk to doctors and nurses directly and you will see the dynamics will change very quickly in your favor once we start talking to doctors and nurses directly. They then know you have someone on your team that understands intensive care inside out, and then you get real answers. We can advocate for your loved one very, very quickly and like I said, that also includes access to the medical records.

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 intensive 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 with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

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 why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, 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 simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking 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 in case 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, and 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 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, 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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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.