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Hi, it’s 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, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of  “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question was

What are the Risks that My Dad Might Face After a Tracheostomy in ICU?

You can check out last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED”  I want to answer questions from one of my clients Isaac, as part of my 1:1 consulting and advocacy service! Isaac’s dad has a tracheostomy in the ICU. Isaac is asking why it is important to have access to his dad’s medical records in ICU.

Why Is It Important That I Have Access to My Dad’s Medical Records in ICU?

“You can also check out previous 1:1 consulting and advocacy sessions with me and Isaac here.”

Part 1

Part 2

Part 3

Part 4

Part 5

Part 6 

Part 7

Part 8

Patrik:  What about the oncologist? Did the-

Isaac:   They never did a biopsy. They just tested the fluids in his lungs, and it came back-

Patrik:  Sure.

Isaac:  The fluid came back as cancer, so then they staged it at Stage 4. I was shocked. But everything else in his body’s good. I know his lungs are real bad.

Patrik: What about the oncologist? Are you talking to the oncologist?

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Isaac:  Yes, she came in, but she just doesn’t know much.

Patrik: Right. And she doesn’t have a point of view whether he should go to subacute or not?

Isaac:  Yeah, she kind of said but, she said, “But it’s the kind that’s untreatable. And so, it’s all about keeping him comfortable more.”

Patrik: Okay. Well, I would use the following strategy for now, Isaac. So, ask them for a specialist, like a hematologist to look at the blood.

Isaac:  Yeah.

Patrik:  And I would argue you should get the medical records. Have you, for example, even consent for the tracheostomy?

Isaac:  Yeah.

Patrik:  Okay. So then, there is absolutely no. They’re just playing games with you. Then, you should also get the medical records. So, if you’re good enough to sign for a tracheostomy, you’re also good enough to have access to the medical records.

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Isaac:  Yeah, I’m going to go back down there. And if not, I’m going to tell the doctor, “I know you can get them. Can you..”

Patrik:  Oh, of course.

Isaac: “get them and just give them to me?”

Patrik:  Of course. They’re just playing games. You need to buy time and one way to buy time is get access to medical records and ask for a hematologist. Do all of that. In this day in age, they should just send you a link.

Isaac:  So, is his oxygen okay? What is his oxygen level at?

Dan:  It’s 99.

Isaac:  Oh, it is 99?

Dan:  Yeah.

Isaac:   Okay.

Isaac:  Oh, it’s 90?.

Dan:  Yeah.

Isaac: Oh, okay. So then, he’s fine?

Dan:  Yes, he’s fine.

Isaac: Okay. Thank you. 

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Isaac:    Just before he did the procedure, he was at 30%.

Patrik:   And now?

Isaac:   And now he’s at 60.

Patrik: Okay. Have they done a blood test?

Isaac:  Yeah, they did one about 30 minutes ago.

Patrik:  Do you know? Just ask them.

Isaac:  You know when you guys did a blood test on him, was it yesterday or the day before? Do you guys have what his levels were? Yes? Was it the CO2 (carbon dioxide)?

Isaac:   57?

Dan:  Yeah.

Isaac:  Yep. The CO2 (carbon dioxide) was at 57.

Patrik:  Okay.

Patrik: And PO2 (partial pressure of oxygen)?

Isaac:  The PO2 (partial pressure of oxygen) was 57? Yeah, the PO2 was 57.

Patrik:  And the CO2 (carbon dioxide)?

Isaac:  Yeah, they said that was 57, the CO2.

Patrik:  Okay. And what about the PO2 (partial pressure of oxygen)?

Isaac:  What about the PO2?

Dan:  It was..

Isaac:  Oh, they take it from a 100%? It was 300-something.

Patrik:  Sure. So, they would’ve.. Yeah, okay.

Isaac:   Is it 30? Yeah. Procedure? Yeah.

Isaac:   Okay. They’re going to slowly start weaning him down again.

Patrik: Okay. All right. But, CO2 (carbon dioxide) 57 is way too high.

Isaac:  Yeah.

Patrik:   That’s way too high and if it stays too high for too long, he might get a little bit drowsy.

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Isaac:  Yeah.

Patrik:   Right?

Isaac:  Yeah, he’s drowsy right now.

Patrik:  Right. Okay.

Isaac:  What is good CO2 (carbon dioxide)?

Patrik:  CO2 should be between 35 and 45.

Isaac:  Oh, okay.

Patrik:  Right.

Isaac:  I wonder why his is always high?

Patrik:   Does he have asthma or COPD (Chronic Obstructive Pulmonary Disease) as an underlying condition?

Isaac:   COPD, yeah.

Patrik:   Right, so it’s high as a baseline.

Patrik:   Yeah. It’s high as a baseline with COPD. So, 57 might actually be his baseline. It might. I don’t know. I would do the following, Isaac, do not give in with subacute. You need to have a look at those places first, and then you probably have a look and then you probably go back to them and say, “There’s no way I’m going to have my dad go to these places.” And that’s the approach you need to take. But, in the meantime, to buy you time, hematologist and get access to those medical records. There’s no way they can deny you that. There’s no way.

Isaac:   Yeah.

Isaac:  Yeah. I’m going to tell the nurse again right now to tell the doctor that I’m requesting a hematologist, you said?

Patrik:  Yeah, absolutely. I texted you that.

Isaac:   Okay. And then, medical records.

Patrik:  That’s right. The other thing, with the medical records. In this day in age, Isaac, they should just send you a link to a website with a username and a password.

Isaac:   Yeah. I went downstairs to check. I have mine, but I don’t have his.

Patrik:   Right. They’re playing games. I mean, medical records need to be there.

Patrik:  They need to be there. You know, they’re playing games.

Isaac:  Yeah. I’m going to ask again right now.

Patrik:   Absolutely.

Isaac:  I will.

Patrik:  Absolutely.

Isaac:   I need the medical records. Do I need to justify anything to them?

Patrik:  No, you don’t need to justify anything to them. You have a right.

Isaac:  Yeah.

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Patrik:   You have a right.

Isaac:   To get it, yeah. Yeah. And about the feeding tube, just tell them to hold off on it? Or what do I do?

Patrik:   No. He needs some nutrition. He needs some nutrition. You need to.. I feel like you should be getting a feeding tube for him now, but you also need the reassurance. You want the reassurance to not have him go..

Isaac:   Just ship him out.

Patrik:  That’s right, not to ship him out. That’s it. That’s it.

Isaac:  Yeah. That’s what I was telling them. So, she kind of understands, the other case manager, doctor, the main one, who when he first came. She was the one who kind of gave me the problems, you know?

Patrik:  Right. Fair enough.

Isaac:  What do we do in the meantime? Just keep telling them that I want them to check his blood, the specialist to come check his blood, and see why he’s bleeding.

Patrik:  Yeah. He needs a specialist’s input.

Isaac:  Okay.

Patrik: And just.

Isaac:  What about the tracheostomy part, for them to kind of like check if he needs that longer one before he’s going to do it.

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Patrik:  Yeah, look, that part I don’t understand. At the moment, what I’m wondering is, because of the blockage yesterday, I’m wondering whether, because the trach was too short, whether it potentially was sitting on the wall of the.. It’s hard for me to, that’s hard for me to speculate there. Ask them why they want the longer trach and see what they say.

Isaac:  She goes, “Well, we’re monitoring it right now.” She goes, “We moved it straight because it was kind of like on the wall.. but we need to go in and change the whole trach for a longer one.”

Patrik:  Right.

Isaac:  Yeah.

Patrik:  Right. Okay.

Isaac: So, that would be better before he goes to subacute.

Patrik:  Yeah. Look, it’s got to be safe. It’s got to be safe.

Isaac:  Yeah. That’s what I was trying to tell them. I go, “If not, he’s going to go and he’s going to die during the transfer, that first day when he gets to subacute. Like, you guys are just trying to get rid of the problem.”

Patrik:  Right.

Isaac:  Yeah.

Patrik:  Right.

Isaac:    Okay. Yeah. Okay, so, I’m going to talk to them about the medical records right now.

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Patrik:   Absolutely.

Isaac:    And if you could text me that word to tell them, and then I’ll call you tomorrow.

Patrik:   Absolutely. I’ve texted you inner cannula. I’ve texted you hematologist. Was there another word?

Isaac:   That’s it, I think.

Patrik:   That’s it. Yeah. Yeah, okay.

Isaac:   Yeah. All right. Thank you.

Patrik:   Let’s touch base tomorrow. Thank you so much, Isaac.

Isaac:  Yeah, for sure. Thank you.

Patrik:   Thank you.

Isaac:  I appreciate your help.

Patrik:  Thank you. Bye. Bye.

Isaac:   Bye.