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Quick Tip for Families in ICU: Are They Rushing My Mother to be Taken Off the Ventilator in ICU?

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is about an email that we had from a reader, and the reader is Sharon. She says, “My mother is in ICU, had a cardiac arrest, and is on a ventilator. It’s been one week, and the doctor said she has 5 days, then they will put her on a tracheostomy. She’s not brain-dead, but her results show brain damage. Why are they in such a hurry to take her off the ventilator?” So, it comes back to what I’ve been saying for many years that 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 questions to ask. They don’t know what to look for. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. And this is clearly illustrated by this question from Sharon, and it’s okay because it’s such a foreign territory when someone goes into ICU. It takes years of training and working in ICU to really understand what’s happening in intensive care. So, let me explain Sharon, what’s happening here.

So, if your mom is having a tracheostomy in about 5 days, they’re not taking her off the ventilator. If anything, they’re giving her every opportunity to let her wean off the ventilator, assuming she hasn’t been weaned off yet. The challenge with brain damage is that often patients, even if they can come off the ventilator, that they have swallowing issues, that they have speech issues after brain damage after cardiac arrest and a hypoxic brain injury, that in order to protect their airway, they need a tracheostomy and to see whether they can swallow.

If they don’t get a tracheostomy, then they could end up with an aspiration pneumonia because saliva could drip down their trachea and accumulate in the lungs and cause an infection. So, if anything, I do believe with what you’ve shared here, Sharon, they’re doing everything that they can to help your mother get off the ventilator. So, again, keeps coming back to that families in intensive care don’t know what they don’t know.

So, the only question that you should be asking is, what are the chances of getting her off the ventilator before day 10? Because that’s what it looks like to me that day 10 is the sort of cut-off for your mom, and then they want to proceed with the tracheostomy, which makes sense. It’s sort of day 10 to day 14 when you should be doing the tracheostomy.

So, what you should also consider is your mom’s Glasgow Coma Scale. So, what’s a Glasgow Coma Scale? You should have a look on our website, go on our website, intensivecarehotline.com, and type in Glasgow Coma Scale and look up the resources there. I do believe you need to familiarize yourself with a Glasgow Coma Scale to make an accurate assessment of where your mother is at. Because if she can wake up, then maybe she’s able to get off the ventilator and avoiding the tracheostomy. But they’re not in a hurry to get her off the ventilator, it’s the opposite. They’re trying to give her time to get off the ventilator, assuming she can’t get off the ventilator by day 10 or day 14 of mechanical ventilation.

And also, you should be asking, has she been weaned off sedation and opiates? She might have brain damage, but she might still be on opiates in sedation. She might also be on anticonvulsants or antiepileptic medications to prevent seizures because that’s what can happen after hypoxic brain injury. And if she’s on sedation, if she’s on opiates, if she’s also on anticonvulsants or antiepileptic medications to prevent seizures, she may simply be too sedated to be weaned off the ventilator.

So, you can now see why I’m saying that you don’t know what you don’t know, and that you need to ask the right questions and that you need to know what you’re looking for. So, it’s such a complex area, intensive care. You need to understand all the pieces in such a difficult and detailed puzzle.

So, that is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply email us to support@intensivecarehotline.com.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team in a membership area and via email. We are answering questions about intensive care all day, every day, for you, for our members.

If you need a medical record review, please contact us as well at intensivecarehotline.com. We can help you with a medical record review while your loved one is in intensive care or after intensive care. If you suspect medical negligence, we can help you with all of that. And in this day and age, you should get access to medical records at lightning speed. The hospital should just send you a link to a URL, to a website with a username and a password, and then you should have access to the medical records. If you can’t get that, you should be worried about what they have to hide. And it’s a right for you to have access to medical records, not a privilege.

If you like this video, give it a like, give it a thumbs up, subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the notification bell, and comment below what you want to see next, or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.

Take care.

Kind regards,

Patrik

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