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Today’s article is about, “Quick Tip for Families in Intensive Care: ICU Survivor John Reports What It’s Like Being on Propofol vs Midazolam, Listen to His Experience!”

You may also watch the video here on our website https://intensivecarehotline.com/ventilation/quick-tip-for-families-in-intensive-care-icu-survivor-john-reports-what-its-like-being-on-propofol-vs-midazolam-listen-to-his-experience/ or you can continue reading the article below.

Quick Tip for Families in Intensive Care: ICU Survivor John Reports What It’s Like Being on Propofol vs Midazolam, Listen to His Experience!

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

So today, I have an email from John who actually says,

“Hi Patrik,

I have had multiple general anesthetics and I used propofol without Midazolam. I woke up normally with minimal grogginess. When given Midazolam twice, only a small single dosage, it took me hours to shake off the tiredness. I dare to think how if someone is being continually dosed with Midazolam or any benzodiazepine for some length of time can do anything.”

Well, thank you so much, John, for sharing that and giving me the opportunity here to share it with our audience because I think this is critically important for families in intensive care to know, but also for patients in intensive care to know. I also think this is critically important for doctors and nurses to know in ICU what patients actually say about their experience.

I have worked in critical care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. We’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. We have saved countless lives with our consulting and advocacy for families in intensive care. You can verify that on our testimonial section or on our podcast section where we have done some client interviews.

Now, propofol versus Midazolam in intensive care. In a nutshell, propofol is short acting, Midazolam is long acting. Midazolam is classified as a benzodiazepine. Other medications that are benzodiazepines are diazepam, lorazepam, Temazepam, but Midazolam is definitely, probably the strongest in that classification and it is being used as a sedative in intensive care quite frequently. With propofol, short acting, you give it to a patient, the patient goes to sleep pretty quickly. It’s given intravenously usually through a central line or a PICC line. Sometimes it’s given peripherally as well, but most of the time through a central line in ICU. Then when you switch it off, a patient wakes up pretty quickly, assuming they don’t have a brain injury and assuming they are not having high doses of opiates such as morphine or fentanyl.

Now, with Midazolam, or also known as Versed in the U.S. or in North America, it’s long acting. You give Midazolam and then patients don’t wake up for long periods of times because it has the effect that it stays around in the tissues of the patient or of a person and then patients don’t wake up. Also with Midazolam, benzodiazepines in general, can be addictive. So, if you keep patients on Midazolam for too long, they can go through withdrawal and that can show up in all sorts of forms. You then have to treat, all of a sudden, withdrawal from benzodiazepines; not a good situation to be in.

So, when is propofol being used? When is midazolam being used? Well, generally speaking, for short-term sedation in ICU, use propofol. For long-term sedation, you use Midazolam, but that comes with undesirable side effects often. Also, side effects from propofol, for example, is hypotension i.e. low blood pressure. You give the patient some propofol and that drop their blood pressure, and then you might need to support the blood pressure with inotropes or vasopressors, also not a good situation to be in.  However, I’ve seen after having looked after thousands of critically ill patients in intensive care, as a nurse, that when you switch off Midazolam, patients may not wake up for hours, sometimes for days, and sometimes even longer depending on how much they’ve had, how they can metabolize it, and so forth.

So again, thank you John for sharing this. I guess in the bigger scheme of things, what is important to understand from John’s email is if you don’t need sedation at all, that’s the best. The sooner you can get someone off the ventilator in intensive care and not use sedation. Because really, sedation and opiates are used in intensive care to intubate someone i.e. put them on the ventilator with a breathing tube and then you want to wean them off as quickly as possible, and that is the best cure to avoid sedatives and opiates. I’ve written an article and made a video about how to wean a critically ill patient off the ventilator and the breathing tube and I will link towards that article below this video.

So, thank you, once again, John, for sharing your experience. I think it’s very valuable for anyone watching this who has a loved one in intensive care. It’s valuable for doctors, nurses, anyone that has an affiliation with intensive care or also anesthetics, of course. It’s also important for doctors, nurses in anesthetics, but also for patients.

Now, because we get so many families asking us questions when they have a loved one in intensive care, that’s why we created the membership for families of critically ill patients in intensive care and you can get access to the membership if you go to intensivecarehotline.com if you click on the membership link there, or if 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. You also have exclusive access to 21 eBooks and 21 videos in the membership. Those videos and eBooks, I have personally written and recorded sharing all my more than two decades worth of intensive care nursing experience making sure you make informed decisions, you have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment.

I also offer one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly and I handhold you through the experience having a loved one critically ill in intensive care. Once again, making sure you make informed decisions, you have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment. I also talk to doctors and nurses directly and I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one in intensive care, once again, making sure your loved one gets best care and treatment.

We also do medical record reviews in real time if you have unanswered questions, if you need closure, or if you are suspecting medical negligence. We do that for you. 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.

I also represent you in family meetings with intensive care teams. Once again, I’ll make sure I ask all the right questions so that you can manage intensive care teams, so they don’t manage you.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send 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, and comment below what you want to see next, what questions and insights you have.

Thank you so much for watching.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification if you are a subscriber to my YouTube channel or if you’re a subscriber to our email newsletter at intensivecarehotline.com.

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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