My name is Patrik Hutzel from Intensivecarehotline.com, and here is another quick tip for families in intensive care.

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

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

“Hi Patrik,

My dad is 50 years of age and he’s currently in ICU. He has pulmonary fibrosis and has been having an infection with pneumonia. He’s in an induced coma and doctors are trying to find an antibiotic that will work. A doctor mentioned a tracheostomy today as the next step. 

Do you think this would be possible with his condition? What are your thoughts? Would this even be effective with his condition? Would this cause him even more pain and suffering?

I would really appreciate your reply.

Roisin”

So, I’m very sorry, Roisin, to hear about your dad’s situation at 50 years of age with pulmonary fibrosis and pneumonia in ICU. This is incredibly challenging and stressful for you and your family.

Let me break down what’s happening with pulmonary fibrosis in ICU and give you some clarity around treatment options for pulmonary fibrosis in ICU, tracheostomy question, and most importantly, how you can advocate effectively for your dad right now.

When someone with pulmonary fibrosis develops pneumonia and ends up in ICU or in intensive care, the lungs are already compromised. The scarring of lung tissue from pulmonary fibrosis means the lungs cannot expand and exchange oxygen effectively, and now with pneumonia on top, the situation becomes critical, which is most likely what got your dad into ICU in the first place.

Let’s look at the mechanical ventilation issue right now.

Your dad is in an induced coma on a ventilator because his lungs can’t do the work in their own right, for now. The ventilator is supporting him while the medical team is trying to find the right antibiotic to treat the pneumonia. Finding the right antibiotic is absolutely crucial. With pulmonary fibrosis, infections can be harder to treat because the scarred lung tissue doesn’t heal very well. Antibiotics may not penetrate as effectively. The immune response may be compromised.

The tracheostomy question.

And the doctor mentioning a tracheostomy is actually a conversation you should have in detail with them, and this is where having access to all medical records and having a consulting call with myself or another team member at intensivecarehotline.com with yourself, your family, and the ICU team will help clarify the situation.

And yes, a tracheostomy is absolutely possible with pulmonary fibrosis, and here’s why the ICU team might be considering it.

The benefits of a tracheostomy are:

1. More comfortable than a breathing tube through the mouth, which refers back to your question, when you say, how comfortable will a tracheostomy be? So, it’s way more comfortable than a breathing tube.
2. It allows for better sedation, meaning in most cases I have seen that sedation and opiates can be stopped immediately, because really a tracheostomy is not very painful.
3. It’s much easier to clear secretions. It may allow your dad to be more awake and interactive once sedation and opiates have been stopped.
4. It also reduces the risk of ventilator associated pneumonia. If long-term ventilation is needed, it’s safer and more comfortable.

And the real question isn’t whether it’s possible, but whether it’s the right choice given your dad’s prognosis and quality of life goals.

With pulmonary fibrosis, we need to consider:

1. Can the pneumonia be clear?
2. What’s the progression of pulmonary fibrosis, i.e., is it getting worse?
3. Can he potentially be weaned off the ventilator?
4. What would his quality of life be?
5. What are his wishes?

So, a tracheostomy typically causes less discomfort than keeping a breathing tube through the mouth long-term, and once again, the tube through the mouth requires heavy sedation and opiates and an induced coma.

A tracheostomy allows definitely for lighter sedation and in most cases that I’ve seen, no sedation. Your dad could potentially be more awake and aware. It’s more comfortable for long-term ventilation, however, the bigger question is about the overall trajectory. This is where we can question and advocate on your behalf.

Again, get access to all medical records you need, complete transparency. Request all medical records, which include all imaging, chest X-rays, CT scans, pulmonary function tests from before this admission, microbiology results, what bacteria they are finding, ventilator settings and oxygen requirements, and the progression of pulmonary fibrosis. Get access to all doctors, nurses reports, physical therapy, physiotherapy, OT, fluid balance charts, lab results, medication charts. Leave no stone unturned because having access to all medical records is your right, and it’s absolutely essential for making informed decisions.

And schedule a consulting call with me, so that we can help you to clarify the prognosis, question the treatment plan, advocate for your dad’s best interest, understand if the tracheostomy is for comfort, for weaning, or for long-term ventilation. Get a second opinion on the treatment approach. And we can question and advocate in ways that family members simply can’t because we understand the medical terminology, the ventilator settings, medications, and realistic outcomes. Also understand the long-term picture.

If your dad needs long-term ventilation, which could be invasive with a tracheostomy or non-invasive, or he needs a tracheostomy without ventilation because he can’t be weaned off the tracheostomy and or the ventilator, you need to know about intensivecareathome.com. It’s a long-term option to keep your dad out of ICU predictably and permanently if he requires long-term ventilation, invasive or non-invasive, if he needs tracheostomy care, even palliative care with dignity at home. Intensivecareathome.com provides specialized nursing equipment and support to care for critically ill patients at home rather than in ICU indefinitely.

The questions you should be asking the ICU team:

1. What’s the likelihood the pneumonia will clear with antibiotics?
2. What’s the progression of pulmonary fibrosis? Is it stable or advancing?
3. Is the tracheostomy being considered for comfort, for weaning, or because you expect long-term ventilation?
4. What’s a realistic timeline for weaning off the ventilator?
5. What would his quality of life be like if he survived this?
6. What are the treatment options if he can’t be weaned?

Roisin, families shouldn’t have to figure this out alone, the medical jargon, the uncertainty, the life and death decisions. It’s overwhelming.

Contact us at intensivecarehotline.com today for a consultation call, get access to all medical records, let us review them for you. We’ll help you question and advocate effectively. We’ll give you a realistic assessment and help you make informed decisions. And if long-term ventilation and or tracheostomy becomes the path forward, intensivecareathome.com is the best option to bring your dad home with the care he needs. Don’t wait. Every day in ICU matters.

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.