Hi there!
Today’s article is about, “Quick Tip for Families
in Intensive Care: My Mom's in ICU with Liver Failure Not Waking Up. Why Did the ICU Ask for a Tracheostomy if She has ARDS (Acute Respiratory Distress Syndrome)?”
You may also watch the video here on our website https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-my-moms-in-icu-with-liver-failure-not-waking-up-why-did-the-icu-ask-for-a-tracheostomy-if-she-has-ards-acute-respiratory-distress-syndrome/ or you can continue reading the article below.
Quick Tip for Families in Intensive Care: My Mom's
in ICU with Liver Failure Not Waking Up. Why Did the ICU Ask for a Tracheostomy if She has ARDS (Acute Respiratory Distress Syndrome)?
Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
Currently, we are working with
a client who has contacted us a few days ago and basically said, “Look, my mom is in ICU. She’s been there for about 10 days, and she is in liver failure. She’s been ventilated and she’s in an induced coma. Now, they’re starting to talk about the tracheostomy. Should I give consent to it?”
So, I said to the client, “Look, I really don’t have enough information about your mom’s situation”, and they didn’t really
know what else was going on when I was probing and asking questions around what medication she’s on? What are blood results? What are arterial blood gases? What do chest x-rays show? What are the ventilator settings? And the list goes on. They didn’t really have an idea.
They also said that intensive care team really hasn’t sat down with them and explained things to them. They were really walking in the dark
and which is sort of clutching at straws really, hearing from the intensive care team, “Well, she needs a tracheostomy. She needs a PEG/Percutaneous Endoscopic Gastrostomy, and they should just give consent”.
But obviously, it’s good that families are doing their own research and that they just don’t jump the gun. It is a once in a lifetime situation when you have a loved one critically in intensive care that you simply can’t afford to get wrong.
So next step was I said to the client, “Look, I either need to talk to the doctors and
nurses directly or we need to look at medical records. Ideally, we do both.” So, we looked at the medical records and here is what we found. So, it turns out that the client’s mom has ARDS or lung failure, and she has stiff lungs, or the compliance of
the lungs is very low. So, she’s on 75% oxygen on the ventilator. She’s in a fully controlled ventilation mode. She can’t breathe for herself at all. She’s also on epoprostenol for ARDS (acute respiratory distress syndrome) and she’s on a PEEP of 10.
Now, I don’t want to bore you with too much medical details. However, here’s what’s important. (A), the family has never been told that she’s got
ARDS or lung failure and with high ventilator settings on 75% FiO2, and the PEEP (positive end expiratory pressure) of 10, in a fully controlled ventilation mode, plus the epoprostenol nebulizer, plus a very poor chest x-ray, plus a very poor arterial blood gas, makes it impossible for now to do a tracheostomy anyway.
So, all the support for the ventilator have to come down. Arterial blood gases
have to improve, chest x-rays have to improve, sedation has to be lowered, opiates have to be lowered for tracheostomy to be even considered.
Now, you’ve heard me say this for years now, for anyone who’s watched my blog for a while, 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, and that is exactly what this family is dealing with.
So, if you have a family member in intensive care, I’m asking you, what is
it that you don’t know? What is it that you haven’t been told? What are the questions you haven’t asked?
Part of our skills here at intensivecarehotline.com is we ask all the questions that you haven’t even considered asking. The reason I can ask the questions that you haven’t even considered asking is that I worked in critical care for nearly 25 years in three different countries
where I worked as a nurse manager for over 5 years and where I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can confidently say that we have saved many lives with our consulting and advocacy. You can just look at our testimonial section at intensivecarehotline.com.
That’s also one of the reasons why we created a membership for families of critically ill patients in intensive care. You can become a member, and you can get access to me and my team if you go to intensivecarehotline.com, you click on the membership link or 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 e-books and 21 videos that I have personally written and recorded, sharing all my vast nursing experience in critical care and the content is designed for families in intensive care.
I also do one-on-one consulting over the phone, Skype, 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 process that you can’t afford to get wrong. I also talk to doctors and nurses directly. Again, I ask 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. We also do 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 with the goal of your loved one, getting best care and treatment and making sure you make informed decisions, have peace of mind, control, power, and influence.
All of
that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com with your questions.
If you like my video, subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, share the video with your friends and families.
I also do a weekly YouTube live where I answer your questions live on a show. You get notification for the YouTube live if you subscribe to my YouTube channel or if you are a subscriber to our email newsletter at intensivecarehotline.com.
If you want your email and questions answered very quickly via video, leave a donation here on the YouTube Super chat button and I will read out your email very quickly and answer your question here. I have so many emails sitting in my inbox that I can’t even keep up making all these videos. If you want to leave a small donation anyway, to support the work that we are doing so we can help as many families in intensive care all around the world, that would be
much appreciated.
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.
