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Today's article is about, “Quick Tip for Families in Intensive Care: Mom Isn't Waking Up After Open Heart Surgery, Cardiac Arrest & CPR (Cardiopulmonary Resuscitation), How Long Do We Give Her to Wake Up?”

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Quick Tip for Families in Intensive Care: Mom Isn’t Waking Up After Open Heart Surgery, Cardiac Arrest & CPR (Cardiopulmonary Resuscitation), How Long Do We Give Her to Wake Up?

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

So today, I have a question from Tony who says,

“Hi, Patrik,

My mom isn’t waking up after her open-heart surgery. Her heart did stop, and CPR (Cardiopulmonary resuscitation) was done. How long do we give her to become alert and wake up?”

Tony, I’m very sorry to hear about your mom’s situation. Unfortunately, whenever open heart surgery is performed, the risk of the heart stopping is real. As a matter of fact, during most open-heart surgeries, the heart is being stopped artificially only to be restarted after open-heart surgery is performed. If the heart is being stopped during open heart surgery and a bypass machine will take over the function of the heart and the lung in any case.

So, they did CPR. Obviously, the question is number one, how long did they do CPR for? Number two, was it effective? Now, I argue if your mom was on a bypass machine during cardiac surgery, hopefully, there is no brain damage. You have to find out the ins and outs and that’s why I always say the biggest challenge for families in intensive care is 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.

So, it could well be that they’re giving you the doom and gloom and all the negativity, and they haven’t actually told you that your mom most likely was on the bypass machine during open heart surgery. If the heart stopped and they did CPR, maybe they had time to put her back on the bypass machine. I don’t know, I wasn’t there, but that’s also why it’s so important you ask all those questions. That’s why it’s so important that you get access to medical records.

Also, did the cardiac arrest happen after open heart surgery? Was the chest closed?  Was the chest opened? Did they do CPR on an open chest, on a closed chest? I have many questions around this. I would also hope that because she was in a hospital, either in the operating room or in theater, or in ICU, that CPR would have been effective, much more effective than if she had been outside in the community where there are no medical emergency teams readily available, a medical emergency team dealing with CPR and cardiac arrest is readily available in the hospital and they’re highly trained. So, you would think that CPR would have been much more effective than in the community.

So, taking that aside and having gone through, what you should be looking for here. So now, the question is, is she not waking up because she’s simply too sick? Is she not waking up because she’s potentially over sedated, and having too many opiates? Is she not waking up because she’s hemodynamically unstable, i.e., her vital signs are unstable? Is her blood pressure stable? Is her heart rate stable, which could be an issue in and of itself after CPR and open-heart surgery? She might be in an irregular heart rhythm such as AF or A-Fib (Atrial Fibrillation), which is not uncommon after heart surgery. It’s certainly not uncommon after open heart surgery and CPR.

So, is that one of the reasons why they keep her sedated and on opiates?

Has brain damage been sustained? If they think brain damage has been sustained, has a CT (Computed Tomography) scan of the brain been done? Has an MRI (Magnetic Resonance Imaging) scan of the brain been done? Has an EEG (Electroencephalography) been done? Has a referral been made to a neurologist?

What sedatives is she on? If she’s potentially having brain damage, does she have seizures or is she at risk of having seizures? Has she been through cooling therapy if she had a cardiac arrest and CPR to protect the brain as well as protecting other organs? Those are all questions you need to ask.

Also, is she on inotropes or vasopressors or potentially vasodilator to maintain either blood pressure that’s compatible with life? Or if she’s on vasodilator, is she having high blood pressure that needs to come down? Is she potentially in kidney failure? As some patients can go into kidney failure after open heart surgery and cardiac arrest because the kidneys are not perfused well enough, and therefore, patients go into kidney failure often.

If she’s in kidney failure, is that contributing to her not waking up because opiates or sedatives are not being excreted through the kidney and they’re accumulating in the body? Those are all questions you need to consider in a situation like that.

Now, how long do you give her to wake up? Again, is she still on sedation? Is she still on opiates such as morphine or fentanyl? Is she having anti-seizure medications to suppress seizure activity which also has some sedative effect? You need to look at all the things that I just mentioned in order to answer your question, how long do you give someone to wake up?

Do you want your mom to wake up? I presume, yes. So then, how much time do you give her? Do you give her 2 days? Do you give her 2 weeks? Do you give her 2 months? Do you give her 2 years? I don’t have the answer to those questions. Only you can answer that question how much time you give her to wake up.

I hope that helps Tony. If you have any other questions, please let me know.

I have worked in critical care for nearly 25 years in three different countries. I’ve also worked as a nurse manager for over 5 years in critical care. I have been consulting and advocating for families in intensive care all over the world since 2013 here at intensivecarehotline.com.

I can say without the shadow of a doubt that we have saved many lives through our consulting and advocacy . You can verify that at our testimonial page at intensivecarehotline.com. If you click on our testimonial  section or if you go to our podcast section where you can watch some client interviews.

Because we get so many questions for families in intensive care, that’s why we created a membership for families of critically patients in intensive care at intensivecarehotline.com. You can click on the membership link there to get access to the membership or you can 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.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. But I also talk to intensive care teams, doctors, and nurses directly making sure that you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment. I also ask all the questions the doctors and nurses that you haven’t even considered asking that come from all my experience.

I also represent you in family meetings with intensive care teams, making sure you have a strategy when you go there. But also making sure that going there is the right thing to do in the first place. It’s all about having a strategy, making sure once again, your loved one gets best care and treatment.

Also, we are offering medical record reviews in real time so that you can make informed decisions, have peace of mind, control, power, and influence in real time when you have a loved one in intensive care, and basically, you can have a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

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 support@intensivecarehotline.com with your questions.

If you like my videos, subscribe to my 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.

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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