Quick Tip for Families in Intensive Care: Why ICU Overuses Sedation and How Families Can Advocate for Their Loved Ones?

“Why some ICUs sometimes overuse sedation and how families can advocate for their loved ones?”

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 gets best care and treatment always, even if you’re not a doctor or a nurse in intensive care.

So, today’s question comes from Dominique, who asks:

“Hi Patrik,

My husband is in the ICU, and it is almost like they’re testing to see how close he is to death with their hidden agenda. About a week ago, they told me his brain is very good as he woke up within 2 minutes and he did a few commands and they sedated him again, which I was happy about because I was told that they were going to keep him awake.

One time, they went to wake him up, and he reached straight away for the breathing tube. What do they do instead of exploring all different alternatives to keep him awake and to relax him? They sedate him and sedation is getting overused. I felt they were testing to see if their drugs have affected him yet and if not, instead of waking him up and progress well, they hindered his progress to fit the narrative. That is very sick, because obviously I know from that operation he’s not as sick as they are portraying.

I see another agenda happening in front of my eyes, and they are denying, avoiding my questions. All of the questions are about my husband’s health and well-being. I want to understand better to be the best for him. Am I doing the right thing?

From, Dominique.”

Well, thank you so much for your question, Dominique, and for sharing your husband’s situation and shedding some light on this situation because I believe a lot of other families in intensive care are going through the same, and unfortunately, what you’re describing is very common in intensive care and you’re absolutely right to be asking these questions.

ICU teams often overuse sedation because it makes patient management much easier for them, but it doesn’t always serve the patient’s best interests. Sedation is often delaying waking up, delay ventilation weaning, and can even create the illusion that your loved one is “sicker” than they really are.

From what you’re sharing, your husband has already shown signs of neurological responsiveness and strength, which is very positive. The longer you keep patients sedated and in an induced coma, the higher chances they get deconditioned. They are wasting their muscles, and it’s getting much, much harder to wean off the ventilator, and then the next step might be that patients need a tracheostomy.

So, when a patient actually tries to pull out their breathing tube, the first reflex of ICU staff is often to sedate instead of addressing discomfort, anxiety, or communication needs and communication deficiencies. Alternatives such as pain relief, reassurance, repositioning, physical comfort, or even discussing early tracheostomy to make things easier are often ignored in favor of sedation.

Unfortunately, this keeps families in intensive care in the dark and feeds into the agenda of controlling the narrative and the bed management and the financial processes in intensive care. If a patient is trying to pull out their breathing tube by themselves, that’s actually a good sign. Now, obviously, it needs to be done safely, and if a patient just strips out the breathing tube, it’s often not safe.

So, the question is, are you doing the right thing? Yes, absolutely. By asking questions, observing carefully and refusing to accept vague answers, you’re advocating for your husband. ICU teams often have competing interests, such as freeing up ICU beds, financial management, or simply making things easier for staff and also keeping staff happy. That’s why families in intensive care who ask the right questions and seek second opinions are the ones who influence better outcomes.

My advice. Number 1, you need to get access to the medical records. Let me repeat that because it’s so important. You need to get access to all medical records, because only then can you really get a second opinion and then also, it’s the only way for you to determine that what you’re seeing in reality and what they are telling you is actually what’s happening in reality.

I cannot tell you how many times we’ve looked at medical records as a second opinion, and ICU teams are telling a completely different story to what we are finding in the medical records. So, it is absolutely imperative to get access to the medical records. In 2025, it should be no more difficult, no more complicated than you getting access to all medical records through a website, through a username and a password, or through an online app. Most hospitals now have apps where they store the medical records, so don’t overcomplicate that.

Next, keep questioning sedation use and ask for sedation breaks like spontaneous awakening trials. Ask why sedation is necessary instead of exploring alternatives. Ask what sedatives and opiates are being used. Is it propofol, midazolam/Versed, is it Precedex? Is it fentanyl or morphine? Also, ask for the side effects of these because those side effects are often hindering waking up and weaning off the ventilator. So, ask why sedation is necessary instead of exploring alternatives. Insist on regular neurological assessments when sedation is off.

If your husband can follow commands and shows responsiveness, that’s very encouraging. Push for early extubation ideally, and if they can’t extubate, maybe they can if they put him on BIPAP (Bi-level Positive Airway Pressure) or on CPAP (Continuous Positive Airway Pressure) or on high flow nasal prongs. If that can’t be achieved, you might want to start thinking or even push for a tracheostomy if prolonged ventilation is expected and necessary, as it often reduces the need for sedation and opiates.

Always remember, in intensive care, if you don’t question, you don’t get the answers. The reality is ICU teams will not volunteer information unless you ask specifically. You are absolutely doing the right thing, Dominique. Keep going!

But you need to get access to the medical records because that’s how we can help you the quickest, by looking at medical records and matching to what we find in the medical records to what’s really going on and what you are observing and what the ICU team is telling you.

So, if you want peace of mind, control, power and influence when your loved one is critically ill in intensive care, go to intensivecarehotline.com where you can get access to me and my one-on-one consulting and advocacy. You can also check out our membership for families in intensive care at intensivecaresupport.org.

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.