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Quick Tip for Families in Intensive Care: What are the Best Questions to Ask for My Brother Who’s Been on a Ventilator in ICU for 14 Days?
A few days ago, I answered a question from a client who said, “My brother is in ICU on ventilation for 14 days. His blood gas exchange isn’t well; can he get better?” Today, I want to look at specific questions what to ask for a situation like that so you can be prepared if your family member is in a similar situation in ICU.
My name is Patrik Hutzel from intensivecarehotline.com. This is another quick tip for families in intensive care.
So today, we want to look at specific questions to ask the ICU team or prepare for a family meeting for a situation like that. The list of specific, respectful, of course, questions you can ask for your brother’s ICU team to advocate for his best care and treatment are, Number 1, questions about current status. What is the current cause of this poor gas exchange? Is it due to infection, inflammation, fluid buildup, scarring or even lung collapse? What do his recent arterial blood gas values show as for trends over the last 3 to 5 days, especially PaO2 (partial pressure of oxygen), PaCO2 (partial pressure of carbon dioxide), and pH (potential of hydrogen)? So, oxygen in the arteries, carbon dioxide in the arteries, and pH. Oxygen levels should be above 70 mmHg and PCO2 or carbon dioxide should be between 35 to 45 mmHg.
Next, how are his lungs responding to the ventilator settings? Are his lungs stiff? Is there low lung compliance? Is oxygenation improving with current settings?
Questions about next steps. Is a tracheostomy being considered? If not, why? Bear in mind, after 10 to 14 days on a ventilator with a breathing tube, a tracheostomy is often considered safer and better for recovery. Ask them if they’re aware of the timelines and criteria to decide when to perform a tracheostomy and the criteria is usually after 10 to 14 days off ventilation with the breathing tube and the inability to wean off a ventilator. I’ve written an article and made a video about, “How long can a patient be on a breathing tube before needing a tracheostomy?” and I will link to that video below the written version of this blog.
Next, have any steps been taken to start weaning off the ventilator? Ask about spontaneous breathing trials or sedation and opiate reduction.
Next, would your brother benefit from a transfer to a long-term acute care hospital? But that’s only if you are in the U.S. and it’s a question you should be asking. By the same token, I can tell you, do not go to an LTAC, but you should mention it before they mention it, and you should be prepared about it.
Then, questions about broader care. Is a pulmonologist, respiratory therapist, respiratory physician, or critical care specialist closely involved in your brother’s care? Are there any signs of ventilator associated pneumonia or other complications? And if so, are they being addressed? Is there anything more we could be doing right now to give him the best chance of recovery?
What’s important there is intensive care teams are only telling families in intensive care half of the story, half of the truth. I can almost guarantee you that when I start asking questions, that there’s things coming to light that you haven’t even considered. Intensive care teams only tell you half of the story unless you have someone on your team that understands intensive care inside out and knows what to look for at all times.
So, I hope that helps you with a situation like that if your family member can’t come off the ventilator.
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 critical 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 for our clients in intensive care.
You can verify that if you go to our intensivecarehotline.com testimonial section at intensivecarehotline.com or if you go to intensivecarehotline.com podcast section where we have done client interviews. Because our advice is absolutely life changing, that’s why you can join a growing number of members and clients that we have helped over the years to improve their lives instantly when they have a loved one critically ill in intensive care, so that they can make informed decisions, have peace of mind, control, power and influence, make sure the loved ones get best care and treatment, always.
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 can’t afford to get wrong. I also talked to doctors and nurses directly with you on your behalf, I set you up with the right questions to ask. When I do that, I ask 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.
The biggest challenge for families in intensive care is that the 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, they don’t know how to manage doctors and nurses in intensive care. That is what you are up against.
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 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. 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 videos and 21 e-books that only are exclusively accessible to our members. All of that will help you to 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 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.
I also do a weekly YouTube live where I answer your questions live on a show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to 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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