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Quick Tip for Families in Intensive Care: They Say The Ventilator’s Causing Damage After 24 Days But Won’t Do Surgery for a Tracheostomy?

They say the ventilator’s causing damage after 24 days in ICU on a ventilator with a breathing tube, but they won’t do surgery for a tracheostomy. Help!

My name is Patrik Hutzel from intensivecarehotline.com and this is another quick tip for families in intensive care.

We are always sharing updates and real-world situations for families in Intensive Care.

Now here’s the situation.

I see families in intensive care all the time, and it just doesn’t make sense. They’re telling you, the ventilator has been in for too long, it’s past 24 days now, it could cause permanent damage. But in the same breath, ICU team say, we don’t want to put him under anesthesia to do the tracheostomy, so, which one is it? Telling me the breathing tube is now dangerous, but you’re not willing to do what’s necessary to replace it with something safer, like a tracheostomy.

Let me break this down for you. When someone is ventilated with a breathing tube or endotracheal tube for more than 10 to 14 days, tracheostomy is generally the next logical step. I have made countless videos about this, that it’s usually a 10-to-14-day window, and research is supporting that.

A tracheostomy is more comfortable, easier to wean off the ventilator, and lowers the risk of long-term complications like vocal cord damage, tracheal stenosis, or ventilator associated pneumonia. If they’re saying we’ve gone past the safe point for ventilation, they’re technically correct, 24 days.

It’s way too long to have an endotracheal tube in. But if they don’t want to do the tracheostomy, then you’ve got to ask, what’s their plan? Are they just waiting for the patient to die? Are they potentially withholding necessary treatment, or are they being overly cautious with anesthesia because of other risks like instability or neurological issues. Even then, there are ways to do a tracheostomy safely at the bedside without general anesthesia. It can be done under local anesthesia with sedation. I’ve seen it happen many times, especially when someone is too unstable to go to the operating room, but often this is less about medical facts and more about hospital policies, risk aversion, and let’s be blunt, limiting costs or resources.

Here is why you need to question everything. You need to ask if the breathing tube is now unsafe, what’s the safer alternative? Why is the tracheostomy off the table if it’s clinically indicated? Can it be done under local anesthesia? What’s the risk of not doing it? If they don’t give you clear logical answers, it’s time to escalate and bring in a second opinion. Don’t let mixed messages and half truths decide your loved one’s future and fate.

This is why I do what I do at intensivecarehotline.com to help you hold intensive care teams accountable, ask the right questions, and make sure your family member is getting the care and treatment they need, want, and deserve.

Just as a bonus point, if they’re saying they don’t want to put your loved one under anesthesia to do a tracheostomy. So, here’s a crucial point when it comes to tracheostomy versus breathing tube in the mouth. When someone is needing a breathing tube, they’re much more likely to need sedatives and opiates. Because a breathing tube can be extremely uncomfortable.

The only way to tolerate mechanical ventilation with a breathing tube in the mouth and a ventilator is often with lot of sedation and opiates. Opiates are strong painkillers such as fentanyl or morphine. Commonly used sedatives in intensive care are midazolam or Versed, propofol and sometimes Precedex. To say your loved one wouldn’t tolerate an anesthesia is often not accurate because when your loved one is in an induced coma to be able to tolerate the breathing tube, that to a degree is anesthesia because they are drugs commonly used to put someone asleep to do a surgical procedure. Just keep that in mind, and this is why I keep saying over and over again.

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. That is exactly what most families are dealing with.

Most intensive care teams are not even telling families in intensive care or half of what’s going on or half of what’s really going on, and that’s why you need us here at intensivecarehotline.com. We can help you navigate this incredibly difficult territory. I also highly recommend that you, whether you engage us or not, that you get access to the medical records one way or another, so you can actually have a look and see whether they are transparent with you, whether what they’re telling you is actually matching what’s in the medical records.

I have worked in critical care nursing for 25 years in 3 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, very, very confidently say that we have saved many lives with our consulting and advocacy, because of our insights, and you can verify that on our testimonial section at intensivecarehotline.com. and 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 hand hold 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, if you need to 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. And 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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