Quick Tip for Families in Intensive Care: The Top 10 Questions to Ask Before a Tracheostomy in Intensive Care

The top 10 questions to ask before a tracheostomy in intensive care.

My name is Patrik Hutzel from intensivecarehotline.com, where we instantly improve the lives of 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 gets the best care and treatment always, even if you’re not a doctor or a nurse in intensive care.

Today’s question is, “The top 10 questions to ask before a tracheostomy in intensive care.” These are questions that you should apply to your loved one in intensive care, because too many families in intensive care are pressured into a tracheostomy without fully understanding the implications.

That’s why I’m going to give you the top 10 questions you must ask the ICU team before saying yes to a tracheostomy.

Let’s dive right into it.

1. Why exactly is my loved one not coming off the ventilator and the breathing tube? Is it weak lungs, muscle weakness, sedation, or neurological reasons?
    
2. What are the chances my loved one can be weaned off the ventilator with or without a tracheostomy? You need numbers, not vague answers. You need a weaning plan. And that’s why I’ve also made a video, “How to wean a critically ill patient off the breathing tube and the ventilator?”, and I’ll show you step by step how that is achieved.
    
3. How long do you expect my loved one to need the tracheostomy and the ventilator? Temporary or long term? And you got to break this down, break down this question even further. If they need ongoing ventilation and tracheostomy, how long? Do they need ongoing tracheostomy, but potentially ventilation once they’ve weaned off? The devil is in the details. The biggest challenge for families in intensive care is 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.
    
4. What are the risks of not doing a tracheostomy now? Is it truly urgent or is the ICU just pushing? If they’re not doing a tracheostomy right now, is your loved one deconditioning because they need more sedation, more opiates? Are their muscles deteriorating and then it’s even more difficult to wean them off the ventilator.
    
5. What are the risks and complications of the tracheostomy itself? Bleeding, infection, airway issues, make them spell it out. Or is it just self-serving that they want to do a tracheostomy right now?
    
6. How will a tracheostomy impact quality of life and recovery?
   Will it help with comfort, communication and eating down the line? Especially with comfort, one of the main reasons to do a tracheostomy is to stop sedation and opiates. Keep that in mind.
    
7. Is the ICU recommending tracheostomy for my loved one’s benefit or for bed management and premature discharge planning? ICUs often want to move patients to LTACs or rehab facilities quickly if they are in the United States. This question is exclusively for our clients in the United States, because there, patients are often prematurely pushed into a tracheostomy so that they can move them to an LTAC (Long-Term Acute Care), which is exclusively available only in the United States. And we strongly advise against LTACs. LTACs are not equipped to look after tracheostomy and ventilation, full stop.
    
8. What are the alternatives to a tracheostomy? Can my loved one be given more time with the breathing tube? Are there other options such as BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) high flow nasal prongs, physiotherapy, mobilization, etc.?
    
9. Who will manage the tracheostomy after ICU? Is it even possible to manage a tracheostomy after ICU? Will my loved one go to LTAC, again, this is exclusively for the United States, rehab or nursing home again, exclusively for the United States, or could they even go home with the right support, such as intensivecareathome.com. I strongly encourage you to go to intensivecareathome.com for more information, because that is where a ventilator and a tracheostomy can be managed safely after ICU.
    
10. What is the long-term prognosis with or without a tracheostomy? You must understand the bigger picture, not just the next steps. The bottom line is this, a tracheostomy can be life-saving and improve comfort for patients needing prolonged ventilation. Or if they have neurological conditions that cause swallowing issues, or if they have conditions where they can’t cough so that secretions can be managed, but it can also be the first step in your loved one being “warehoused in long-term care”, especially again in the United States.
     
    If you don’t ask the right questions and if you don’t get the right advocacy, that’s why you need to be in control of the decisions, not the ICU team.

Here at intensivecarehotline.com, we have families like yours to take back control, ask the right questions, and make informed decisions that are best for your critically ill loved one.

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.

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, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel or my intensivecarehotline.com email newsletter at intensivecarehotline.com.

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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