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!
You can click on this YouTube link to watch the video for today’s blog post:
https://youtu.be/fnBK7jVzmTc
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 is the Next Step for My Ventilated Daughter After Tracheostomy in the 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 am here with a live stream today, where I want to answer your questions if you have a loved one in intensive care. And this is one of the most commonly asked
questions for families in intensive care and it’s a question that we get all time. And today’s live stream is about a mom who had a hypoxic brain injury after cardiac arrest and she’s not waking up in ICU.
Mom Had a Hypoxic Brain Injury After Cardiac Arrest. She’s Not Waking up in ICU! Live stream!
Welcome to another livestream from intensivecarehotline.com. My name is Patrik Hutzel. I’m a critical care nurse consultant, also the founder of intensivecarehotline.com. And I want to welcome you to another livestream today.
Today’s livestream is about, “My mom is in ICU after cardiac arrest and hypoxic
brain injury. She’s not waking up and what should we do?” This is quite a common scenario, unfortunately, in ICU and I will talk more about that in a minute. So, before I get into the topic, I want to welcome you and thank you for joining me. And I also want to quickly talk about what makes me qualified talking about this topic that so many families in intensive care want to know about. What makes me qualified in talking about this topic, is simply that I worked in intensive care for over 20
years as a critical care nurse. Out of over 5 of those years, I have worked as a nurse unit manager in intensive care.
I have been consulting and advocating for families in intensive care since 2013. I’m talking to families that have loved ones in intensive care all day, every day, all over the world. And I’m also running and operating an
organization called Intensive Care at Home where we provide intensive home care for long-term intensive care patients at
home.
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So unfortunately, I haven’t done these live streams for quite some time, and I
want to welcome you back. I have been very busy in the last few months, and I’ve been very hands-on with consulting with clients, with helping our team, and looking after our Intensive Care at
Home patients. I’ve been very busy. So, I do apologize because I very much enjoy doing those live streams. I just haven’t had any time.
Just want to welcome Helene. I’ve seen that Helene is here and I’ve also seen that Modema is here. So, please type your questions into the chat pad and keep them on topic if you can. If they’re not on topic, I will get to
those questions at the end of this video. I usually try to keep those livestreams to about 30 or 40 minutes just because I’m conscious of time. I’m also conscious that you probably need to get back to your loved ones, your family. But let’s dive right into today’s topic.
So, “My mom is in ICU after cardiac arrest and hypoxic brain injury. She’s not waking up, what should we do?” So, this is a question we get quite frequently. Instead of my mom, I could say my dad, my
spouse, my brother, my sister, my son, my daughter. Doesn’t matter. Unfortunately, this scenario happens all too common. The way I want to approach this today is I want to briefly break down what happens after cardiac arrest or what can happen after cardiac arrest, the types of cardiac arrests.
There are two types of cardiac arrests: one is out-of-hospital arrest; one is
inside of a hospital. We’re probably more talking today more about the out-of-hospital cardiac arrests because when an out-of-hospital arrest happens, there is not necessarily a by-stander CPR or cardiopulmonary resuscitation straight away. If there is by-stander CPR, it may not be as effective as an in-hospital cardiac arrest where you have intensive care teams coming, running, and all of that. And CPR in a hospital, you would hope would be more effective compared to an out-of-hospital arrest
where you have a bystander CPR that may or may not be effective. Now, what often happens or what’s following a cardiac arrest is a hypoxic brain injury. The reason for that is the brain, or any other organ for that matter, can only be without oxygen for less than 3 minutes. And if there’s an out-of-hospital cardiac arrest, chances that the brain is without oxygen for more than 3 minutes is high. Once CPR is commenced, it may take a while to get circulation back. It may take a while. When I say
it may take more than 3 minutes to get circulation back, to get a heart rhythm back, to get a heartbeat back, to get a blood pressure back, to regain consciousness, if that’s possible at all. And therefore, if oxygen supply to the brain is disrupted for more than 3 minutes, often irreversible brain damage might occur. And that’s when things get tricky.
Patients then end up in ICU or they often end up on a ventilator, often end up in an induced coma. They often end up in the catheter lab to screen the heart with an angiogram. They may have an angioplasty to unblock the coronary arteries if that’s what led to the
cardiac arrest. They sometimes may end up with cardiac surgery to have bypass
grafts. I’m not going into too much detail there today because that’s not really part of our focus. Our focus is what you as a family need to do, what you need to look for if your loved one has a hypoxic brain injury from a cardiac arrest. That’s what I want to focus on today.
Also, on admission to intensive care, patients should be having an MRI scan of the
brain or a CT scan of the brain to determine the level of brain injury. Often, there is cooling therapy in intensive care for 24 hours. Body will be cooled to 30 to 33 degrees Celsius and that happens for 24 hours. Then the body will be warmed up again. Why is that happening? It’s happening because by cooling down the body, major organs will be protected and that’s the main function of that. Now, then what happens after a hypoxic brain injury after cardiac arrest or what can happen? Patients can
end up with seizures. And then that often triggers medication such as Keppra or Phenytoin to minimize the risk of
seizures. And then, it’s often a waiting game. Once sedation is switched off, discontinued, then it’s a waiting game. How does
someone wake up? Do they wake up at all? If they do wake up eventually, what’s their quality of life going to be? There’s a whole myriad of questions and issues that come with this scenario.
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Now, if you had a loved one in intensive care, if you’re having a loved one in
intensive care after cardiac arrest and without hypoxic brain injury, the intensive care team will probably be all over you and say, “Well, the only way to do things that are in the best interest of your mom, of your dad, of your spouse, or whoever that may be is to stop life support because the brain is damaged. Your mom or your dad, whoever may not wake up. And if they do wake up, they won’t recognize anyone and they won’t have any quality of life. And therefore, it’s ‘in the best interest to
stop life support.'” That’s the scenario I have encountered, I don’t know, probably hundreds of times in intensive care. I have been in many family meetings around that topic, and I have been talking to so many families all over the world around this topic. And it’s the same all over again. Which is why it’s also easy for me because intensive care teams pretty much say the same thing over and over again, which is why it’s also easy for me to say the same things over and over again and counteract
the strategies of the intensive care team to get the best outcomes for you and for our clients and for the patients, of course.
So, here’s what I’ve learned in a nutshell. When someone is in intensive care after cardiac arrest and a hypoxic brain injury, they need time.
Intensive care teams often put the
pressure on within 48, 72 hours. You’ve got to make a decision; you’ve got to pull the plug. They say it in nicer ways and they say it much more euphemistic than I’m saying it. I’m a bit blunter here, but you get the gist. You’ve got to pull the plug, your mom, your dad is suffering, if it was you would want me to pull the plug as well. And you go like, “Oh, oh, oh that’s way too much than I can handle. And it’s only been 3 days and, give me time.” And intensive care team, say, “You need to make
a decision and you need to make a decision by tomorrow 1 o’clock whether you want to pull the plug, whether you want hospice,” and at that stage, they’re not even telling you that, for example, a tracheostomy might also be an option if they’re not waking up.
So, they’re only telling you half of the story. And I’ve made countless videos around that, that they’re only telling you half of the story in those situations. And if you’re not asking the right questions, if you’re not looking for
the right things, if you don’t know about your rights, you’ll be fighting a losing battle here. Intensive care teams are very good at getting what they want because families don’t understand the dynamics, they don’t understand agendas of intensive care teams. They don’t understand how intensive care units operate. They don’t want to keep someone long-term in intensive care with an uncertain outcome, because that is their worst-case scenario.
Modema, you’re asking, “What would we want to see and hear about the CT or MRI?” It’s quite simple, you don’t want to see any injuries. A CT or a scan of the brain or an MRI (magnetic resonance imaging) scan of the brain should
give you an indication whether the brain has sustained an infarct or an anoxic brain injury or not. And what you want to see is no injury. But the CT (computed tomography), I’m not, don’t get me wrong, I’m an intensive can nurse by background. I’m not qualified to read a CT scan, but what I can read is a report of the CT scan. The summary. So maybe you want to share, Modema, if you have a loved one in intensive care with that situation, maybe you have access to that CT or MRI report, and you can
share it here. And then we can talk about that as we go along. So, moving along, the biggest danger zone for families when it comes to cardiac arrest and hypoxic brain injury, and I should also say another term that intensive care teams sometimes use is, “Anoxic brain injury.” That’s another term for, “Hypoxic brain injury.” Anyway, cutting the long, short, you and your family and your loved one are most vulnerable in the first 24 to 72 hours, because that’s when the intensive care team will
give you all the doom and gloom. They will give you all the negativity by default. And that’s when your loved one is most vulnerable, that they’re really pushed towards the end-of-life. They say you don’t want your loved one in intensive care for more than three, four or five days because they will be suffering, right? Well, there’s the argument, a lot of patients in intensive care suffer, but also what you also need to know, over 90% of intensive care patients survive intensive care. So, the odds are actually in your loved one’s favor.
Now, I am talking about survival here, I’m not talking about what does quality of life look like once patients leave intensive care, that’s for a whole another debate. We go into that debate as part of this livestream today, but just for you to understand conceptually what we are talking about here, quality of life is a very vague concept, and it’s not up to the intensive care team to decide what is quality of life.
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That’s up to you and to your loved one, what you want and what quality of life is acceptable for you and for your loved one. Because the reality is that if there is a hypoxic brain injury, yes, quality of life after a hypoxic
brain injury is probably not as good as it was before the hypoxic brain injury.
But that doesn’t mean that quality of life or a meaningful quality of life can’t be achieved. The take-home message that I want to give you today really is that quality of life might be achieved over a period of time. And that
the brain might be able to recover parts of it. I’m not a neurologist. I’m talking only about experience here, that I have seen people wake up after a while, after sometimes weeks or months and they have some recollection of what happened. They can have meaningful interactions with their loved ones. I guess that’s what it comes down to. It also gives you then the opportunity or gives your loved one, the opportunity to make up their own mind and let everybody know what they want.
What do they want for their situation? Seen many, many situations where patients have a hypoxic brain injury, but they wake up after weeks or months, yes, they’re not back to where they were before, but they’re in a position
where they can communicate and share with you what they want. What do they want?
I think that’s what it comes down to, it’s not for intensive care teams to make decisions about your loved one’s life or about the perception about your loved one’s quality of life or about the perception, what it takes for
your loved one to go from A to B. To go from intensive care, to survive intensive care and potentially go home. That’s up to you and your family. Also, what might be important here is, do you have an advanced care plan or does your loved one have an advanced care plan? Has it been documented prior to the intensive care admission? What do they want in a situation like that?
Helene, yes, “What if they can no longer speak?” Yes, absolutely. You’re
absolutely right. And there are people that can’t talk after they’ve been admitted to intensive care, after cardiac arrest and hypoxic brain injury. Yes, absolutely. That does happen too. But the reality is this, let’s just say you consent to ending your loved one’s life. And you can do that in the first few days, easily.
You take out the ventilator, you stop all life support, like inotropes and vasopressors, chances that your often will die are fairly high. Then they definitely can’t talk once
they’ve passed away. You’ve got to project yourself out. You’ve got to project yourself 12 months out from the event.
So, the reason I’m saying you got to project yourself 12 months, at least, out to the cardiac arrest and hypoxic brain injury, the reason I’m saying that is, so, if you were to look back in 12 months’ time to current events,
once your loved one has passed away, they’ve passed away. There’s no coming back from that. That’s it. You will have regrets. You will have second thoughts. You will think in 12 months, “Oh, what if?” The loved one has passed away. There are no more what ifs.
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And that’s why I’m saying, yes, you are taking the risk that they can no longer
speak even if they, 6 weeks down the line, they’re waking up a little bit, but they can’t talk. Yes, absolutely. There is a risk for that, but once they’ve passed away, they can definitely no longer speak. And I just want to leave you with those thoughts for now.
So, I read this quote the other day and it really sort of described how I feel
about this topic. As you might have seen or all around the world, there are debates around voluntary euthanasia. Someone wants to end their life and because they are in chronic pain or they have cancer, or for whatever reason they don’t want to live anymore.
Now, I feel a little bit sceptic about voluntary euthanasia because I do believe
it could be taken in the wrong direction. And those voluntary euthanasia rights or laws, whatever you want to call them could be used for evil, I believe. And could be used for involuntary euthanasia. And that’s, what’s happening in intensive care all day, every day. And I have a big problem with that.
And as part of that discussion, I read a quote where it says something along the
lines of, “Give me assisted living over assisted dying any day of the week.” And I think that’s profound. I think that’s profound. Let me say it again. “Give me assisted living over assisted dying every day of the week.” And that’s how I feel about this whole issue.
It takes effort to get a patient to survive intensive care, and there are no
guarantees on the other side that things will turn out the way that you want them to turn out. There’s absolutely no guarantee for that. But, if you’re not trying, there’s 100% no guarantee. There’s no guarantee for life if you’re not trying.
So, that sort of how I feel about the topic. And I also know that a lot of our
families have come to us feel about the topic. Otherwise, they wouldn’t be seeking out for help. And otherwise, they wouldn’t resonate with what we are publishing at intensivecarehotline.com. And most of the videos that I’m making here, are all around the same topics and the same schools of thought.
So, as I mentioned, your loved one is most vulnerable in the first few days
because families feel overwhelmed. They feel like, “Oh, I don’t want my loved one to live on a ventilator.” They haven’t done enough research. They just look at their loved ones and they think, “Oh my goodness, that’s not how I want my loved one to live.” And I get that. It’s terrible the first few days, but that’s also when you and your family are most vulnerable to give in to the intensive care team.
As time goes on, and as you will see
that your loved one will be more stable and your loved one might show signs of waking up. If they’re coming off life support, step by step, you will be more positive that things can improve. But again, I will say, there are no guarantees for that.
I’ll give you a good example, just a very recent example. We are currently working
with a 23-year-old, young man that had a cardiac arrest, probably November 21. They’ve been in ICU for a couple of months, had the tracheostomy. Again, ICU wanted to push for end-of-life. The family was very adamant saying, under no circumstances will we agree to that. And the client ended up with a tracheostomy, got out of ICU, got off the ventilator. And he’s not very conscious at all at the moment. And that’s sort of 3 months in, but they’re feeling like they’re making progress, that they’re
slowly waking up. Yes. Modema, 23, yep. That they’re slowly waking up and that they want to give him a chance. And they’re very patient. They’re prepared to do whatever it takes. And those are the parents. The parents and the girlfriend, that are fighting for him, that are advocating for him. And I’m helping them in putting in the right steps, saying the right things, advocating for the right things. Also, importantly, asking the right questions. But having said that, it doesn’t really matter
whether someone is 23, 43, 63 or 83. The age doesn’t matter, it’s about the principle that, I believe life is sacred and nobody should touch life. It’s, from what I believe, it’s in God’s hand when someone will die.
When we die, it’s not up to anyone playing God. It’s up to everyone, making sure everyone is putting their best foot forward. Now, you might have heard me say earlier that we’re also running an organization, Intensive Care at Home. And I quickly want to talk about that too, because it does tie right in with today’s topic. A lot of patients that we
are looking after at home, they are on ventilation. They’re on tracheostomy.
They may have sustained a cardiac arrest at some point. The bottom line is this, they want to live, their family wants them to live. And yes, they probably have a less than desirable quality of life, but yet they want to live.
And the same is applicable when it comes to hypoxic brain injury after cardiac arrest, it is what is acceptable for you. It is about, do you want to try giving it your best shot. Coming back to the first few days in ICU after cardiac arrest and the confirmed hypoxic brain injury, the intensive care team will put the pressure on you to trying to remove life support. And they’re very good at that because they do it all day, every day and they know which buttons to push so that you give
in.
Now, again, can’t stress that enough, project yourself 12 months out and think about, what if you give in today, what regrets will you have? And I can assure you, you will have regrets. There are so many families coming to us
after 12 months and said, “Oh, I’ve given in a year ago. I agreed to have my mom, my dad be taken off the ventilator after cardiac arrest with hypoxic brain injury. I thought they would never wake up. I didn’t even know there might be other option. I didn’t even know someone can advocate for me. If I had only known.”
And that’s a terrible feeling to have. I know the pressure you are under. I know
the pressure you’re getting from intensive care teams, but think long term, think about what can happen. Think about that. If you haven’t tried, you might you will have regrets.
I just want to leave it there. Now, in the first few days, the intensive care team will try and schedule family meetings with you. They might try and call you out of the blue and say, “Hey, you’ve got to make a decision, this
is not working for your mom, for your dad, for your spouse, whoever… and…” Don’t give in. Don’t go to family meetings unless you have a written agenda. Very important, never go into family meetings with intensive care team until they’ve given you a written agenda so you can prepare yourself. And I highly recommend that you have me there in a family meeting with you so that you have someone that can challenge the intensive care team on a clinical level. If you don’t have someone there that can
ask the right questions to the intensive care team, you will fight a losing battle. Really important.
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Helene, you’re asking, “Can excessive fluid overloads that infiltrated mom’s lungs
to cause cardiac arrest, drowning hypoxia, brain injury, seizure, coma… Yes, absolutely. That can be a scenario, Helene.
That fluid overload can lead to cardiac arrest. I guess, any event, let’s just say someone goes into respiratory arrest because of fluid overload in the lungs, a respiratory arrest that is not treated will inevitably lead to
cardiac arrest because a respiratory arrest means no oxygen is going into the blood, which means eventually no oxygen will go to the heart, which will lead to cardiac arrest. I hope that answers your question, Helene, and then obviously like you’re explaining in your message there, in your question, seizure, coma, tracheostomy, ventilator, absolutely. The whole 9 yards after that. Another thing that is important after cardiac arrest and hypoxic brain injury is, that you know about options. So,
what are the options? The intensive care team will sell you hard and fast on that, end-of-life is the only option.
Now, what are the options? Well, number one, you need to seek neurology input. Neurology has seen this over and over again. They often have a different point of view from intensive care teams. They don’t necessarily have to
have a different point of view, but sometimes they do. And you’ve got to use that to your advantage. You’ve got to talk to neurology. What do they think? You’ve got to talk to the cardiologist, if it was cardiac arrest, what do they see from a cardiology point of view? Do they think it’s likely to happen again, a cardiac arrest? You’ve got to talk to this specialist. Next, you absolutely need to know about tracheostomies as a device that can facilitate buying time for your loved one to wake up.
If they can’t come off a ventilator and often, they can’t come off a ventilator, if they’re unconscious. Which is often part of the hypoxic brain injury that waking up can take a very long time and nothing is going to happen. And you think, oh my goodness, my loved one will never wake up, but we’ve worked with so many clients now that come back to us after 6 months and said, “Look, we didn’t believe initially something was going to happen, but now 6 months down the track, my mom, my dad, my
spouse, my brother, my sister, whoever is now finally waking up and they can communicate,” It does happen.
Again, there is no guarantee for that, but I can give you numerous case studies and we’ve published most of them on our website where you can look them up. Which leads me then to that, you should never give up. And that’s
easier said than done, don’t get me wrong. But we’ve had a client the other day that had a cardiac arrest after COVID. Had, supposedly, hypoxic brain injury. And the family was adamant that they wanted him to wake up so he can make his own decision. And that is exactly what happened. He was in ICU for a very long time. And he eventually was in a position to make his own decision where he said, “Look, I don’t want to live that way.” And that’s great. I mean, how much better is that for a family’s peace of mind, knowing
that he didn’t want to live in that situation with a tracheostomy, with a ventilator, but there would be numerous others that would want to live. And that want to go home with a service like Intensive Care at Home, or that want to go home to spend their last few weeks or months at home.
But for your peace of mind, how much more peace of mind do you have knowing this is what your loved one wants as opposed to this is what the intensive care team is imposing on you? A big difference. It’s a big, big difference
there for your own peace of mind. You know you can sleep at night that you have done everything that you were able to do for your loved one.
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Helene, you’re asking, “Is hypoxic brain injury the same as sense as encephalopathy?” I believe it is. I believe those terms are interchangeable. I believe so. But I couldn’t tell you 100%. I would have to Google it. Anyway,
moving along. And you can Google that yourself, but I’m pretty sure those terms are interchangeable. But I think encephalopathy is more like a dysfunction of the brain, irrespective of the cause of it. But I’ll find out for you. I’ll find out for you.
Now, other things you might see after cardiac arrest, and hypoxic brain injury,
you might actually see some myoclonic jerking. That could be a sign of the brain, not working at all. And it could be a sign of the prognosis being really poor if that’s myoclonic jerking. But, again, you should do your own research. You should do your own research and you should not give up prematurely, definitely not in the first few days. You should not give up in the first few days. Helene encephalopathy says, “It’s a broad term for any brain disease that orders brain function or structure.
Causes include, infection, tumor, and stroke,” That’s what Google says. So, you should not give up prematurely. Also, what can happen sometimes depending on how many days your loved one is on sedation in ICU, you should let sedation wear off. You should also get a good understanding of the Glasgow Coma Scale. And I briefly want to talk about the Glasgow Coma Scale.
It’s a neurological assessment tool that doctors and nurses use in intensive care
to determine neurological function of a patient. And I think it’s a very important and very good tool for you also to keep track of where you are going with this. Very briefly about Glasgow Coma Scale, the maximum score is the number 15. You listening to me, me talking, we have a maximum Glasgow Coma Scale of 15. That’s the maximum score. The lowest score is a Glasgow Coma Scale of three, which is more or less a vegetative state. But even if your loved one for is a Glasgow Coma Scale of 3, which
means, there’s no responses whatsoever even to pain stimuli, that should not stop you from giving up hope and carrying on until you can see an improvement.
Modema, you’re asking, “What would that look like or feel if they’re under sedation and paralytics? What you just said with seizure type thing?” Yeah. If someone is under sedation and potentially even on paralytics, I would
almost argue that you only see the myoclonic jerking once someone is off sedation completely and off paralytics completely. They wouldn’t have any myoclonic jerks on paralytics. They might have myoclonic jerks on sedation and opiates, but it’s less likely. You only see the myoclonic jerks once someone is completely off sedation and definitely completely off paralytics. You can’t, or you shouldn’t paralyze someone without high levels of sedation. You won’t paralyze someone medically without high
levels of sedation. Okay. And I have been in so many meetings, family meetings over the years where palliative care is involved and all they focus on is end of life as being, “In the best interest,” and never with one word will they mention a tracheostomy.
And it’s really important that you’ve got your ducks in a row that you know about
tracheostomy. Do your research, it’s all on our website what you can do. You can call us and all of that. So, very important that you do your own research.
Modema, what do you mean, “What does that look like?” So, myoclonic jerks look like minor seizures. Like a major seizure, really, is where the whole body is shaking vigorously. Patients may not get air in through the
ventilator, and a myoclonic jerk is, or myoclonic jerking is more minor, but it’s more constant or it can be more constant. It’s probably difficult to describe. I’ve seen it so many times. Myoclonic jerking is sort of ongoing rigor, ongoing tremor. It’s hard to describe.
“What about this during stroke, is it similar?” I have seen very few strokes in the moment because the patients that I’ve seen with strokes is post-stroke in ICU. So, I
can’t really describe stroke when it happens at the time, but I wouldn’t think that myoclonic jerks are similar to a stroke. I wouldn’t think so. I think it’s unique to the cardiac arrest/hypoxic brain injury situation. That’s what I think.
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Bear in mind, I haven’t witnessed many strokes. Like, shaking your husband’s…
Yeah. Look, I can’t comment on what you’ve experienced with your husband there. I hope that helps. I want to wrap this up in a minute because I’m conscious of the time, but I certainly don’t want to leave without giving you the option of typing in any questions you still may have as part of this live stream today.
If you have any questions, please type them in now, so I can answer them because I
do want to wrap this up in a couple of minutes.
But again, please ask your questions, fire them away while you can.
Modema, you’re saying, “I’m just curious because I haven’t heard that term before,
so thank you.” It’s a term that’s probably very ICU-specific for this situation. Probably very ICU specific. For that situation. “What comes first, a stroke or a cardiac arrest?” That is a good question.
I would say, it depends. A stroke doesn’t necessarily lead to a cardiac arrest. It can lead to a cardiac arrest. A cardiac arrest doesn’t necessarily lead to a stroke, but it can lead to a stroke. I could have also said as part
of my headline today, I could have said, “Cardiac arrest. My mom now had a stroke and now has a hypoxic brain injury.” Could have said it like that as well. It comes under the classification of an ischemic stroke, which means no oxygen supply to the brain. I hope that clarifies, Helene. So, one could lead to the other.
There are no hard and fast rules, but there may be some research papers out there
about this specific topic, which might occur first. So, I encourage you to do a Google search there. Are there any other questions? While I’m waiting for your questions, “Drowning event?” Yes, a drowning event can lead to a cardiac arrest and a hypoxic brain injury, absolutely. Drowning event often triggers some CPR, yeah. For sure.
So, while I’m waiting for your questions to come in, again, I do want to apologize
that I haven’t these done these live streams for a while. I want to go back into them.
“Hello, can someone recover from hypoxic brain injury?” I covered that, Jeanette. I believe you would’ve just come in now. We are at the end of this session today, Jeanette. I encourage you to watch the live stream once it’s
been uploaded. I’ve covered this today as part of the session. So, watch the live stream once it’s been uploaded.
So, yes, I want to do more of these live streams. Again, I want to get back into the habit of it. As I said, Christmas period has been incredibly busy for me. I didn’t have any time. “What’s the cooling procedure?” Now,
basically, Helene, someone is being cooled, they’re going to lie on a cooling mattress. And obviously the cooling mattress is attached to a heating machine. But the heating machine is also a cooling machine, you can go both ways. And temperature is being cooled down to 32, 33 degrees for 24 hours. And then 32 to 33 degrees Celsius. I don’t know what that is in Fahrenheit, probably around 95, I think. And then, after 24 hours of cooling, the body is being warmed up very slowly by 0.1 degrees
Celsius per hour to not put the body into shock and not to open up the blood vessels too quickly, because that could end up in low blood pressure, could end up in a cardiogenic shock, really.
So, yes, I want to go back into the habit again of these live streams. I want to do them again, Saturday evenings, U.S. time. Sunday morning here, Australia time.
“That was never offered for mom.” Helene, it might not have been offered because it wasn’t in-house arrest. Was it the cardiac arrest in the hospital or was it an out-of-hospital cardiac arrest? Because there is a
difference.
Generally speaking, cooling therapy will often only be offered if it’s an out-of-hospital arrest because of CPR often being delayed out of hospital. Whereas in hospital, CPR should be quick, because you’ve got the teams there.
So that may be one of the reasons why cooling therapy has not been offered. Another reason why cooling therapy has not been offered might be because it was, an asystolic arrest. Maybe it was a VF arrest or a ventricular fibrillation arrest.
So, there are some differences there. Sometimes it won’t be offered, but it’s
usually defined why it’s not offered. So, you may want to go back through your mom’s notes, if you have them and have a look whether it was an asystolic cardiac arrest, or for example, a VF (ventricular fibrillation) or a VT (ventricular tachycardia) arrest. If it was in-hospital, that’s probably the reason why it hasn’t been offered, I would say.
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So, look, I want to go back into the habit again. Again, do them on Saturday nights, U.S. time, which is here, early morning, Sunday morning, Australia time, Melbourne time. I want to get back into the habit. If you have any
topics you want to see, you can type them below. If you want to have any topics covered, you can type them below. Other than that, I have numerous topics that I want to address in those live streams. And I’ll give you another option to answer your last questions before I wrap this up.
If you like this video, give it a thumbs up. Subscribe to my YouTube channel for
regular updates for families in intensive care. Also, regular live streams here. And comment below what you want to see next or what questions you have and click the notification bell.
Also, go to intensivecarehotline.com. If you have a loved one in intensive care, you can call us on one of the numbers on the top of the website or send us an email to support@intensivecarehotline.com.
Helene, “Is it 6:30 or 7:00, U.S.?” You are Eastern Standard Time, I think. Look, it depends a little bit. I tell you, I wasn’t even sure up until half an hour before today, whether I would do this or not, I knew I wanted to do
it. I just wasn’t sure what my schedule was like today. So, I did it at 6:30 today, but I hope that for next week it’ll be 7:00 PM, again. It’ll also change slightly, 7:00 PM Eastern Standard Time. It’ll also change slightly again once the U.S. goes into daylight saving. For us, daylight saving will finish in April. So, the times will change slightly, depending on where daylight saving hours are at. “East Coast,” to Helene, “NC,” North Carolina. So, that’s Eastern Standard Time. So, what time is
it now, East Eastern Standard Time? It’s 11:00 AM here, roughly, 16 hours, which means 11, 5:30- Must be 7:00 PM for you guys on the East Coast. Yes, I’ll try to do them around 7:00 PM Eastern Standard Time on a Saturday night. But then again, when you guys go back into daylight saving in March, it might slightly change. I think it’ll be a little bit later then; it’ll be closer to 8:00 PM Eastern Standard Time. Sonia, I thought it’s 7:00 PM there, yeah.
Okay, guys, I want to wrap this up. I really want to thank you for coming on. I really want to thank you for your support, and I will hopefully talk to you next week. I will also publish some quick tips during the week. So,
keep an eye out for them. And I want to thank you once again, have a wonderful night and all the best to you and your families.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for
now.
