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Today’s article is about, “Quick Tip for Families in Intensive Care: My Husband Didn't Have Chest Drains on Time for Pleural Effusions! Was The Tracheostomy Preventable?”

You may also watch the video here on our website https://intensivecarehotline.com/breathing-tube/quick-tip-for-families-in-intensive-care-my-husband-didnt-have-chest-drains-on-time-for-pleural-effusions-was-the-tracheostomy-preventable/ or you can continue reading the article below.

Quick Tip for Families in Intensive Care: My Husband Didn't Have Chest Drains on Time for Pleural Effusions! Was The Tracheostomy Preventable?

Today I have an email from Shelly who asks, “What you should do with your husband in intensive care who suffered a massive heart attack 23 days ago?” If you want to know the answers to that, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and I have another quick tip for families in intensive care.

So, Shelly writes in, 

“Hi Patrik,

My husband’s suffered a massive heart attack 23 days ago. He was resuscitated and sent to Amarillo, Texas to a trauma center hospital. He was intubated and put on the ventilator. He’s done really well. They attempted to wean him and take him off the ventilator about 6 days later to where he started panicking.

His blood pressure dropped, and they reintubated him. Reintubation means to put a patient back on the ventilator with a breathing tube.

After all of this, I signed consent forms to have drain tubes put in because he had developed pneumonia. These consent forms were signed on Monday, March 3rd. They were not placed in him until Friday, March 6th. That’s the chest tubes were not put in until March 6th after consent had been given on the 3rd of March. Then they did a tracheostomy on the 7th of March, and then a PEG (Percutaneous Endoscopic Gastrostomy) tube on the 8th of March. The plans were to have the drain tubes placed either on the 3rd of March, that night or the next day on March 4th early a.m. He had problems breathing even while on the ventilator.

Now they’re telling me he has infections, they’re not doing anything that I think is helping him. He’s lying there, and they’re not telling me what they waited to do these procedures for. But I feel like this has done more harm than good. They’re now talking about sending him to an LTAC (long-term acute care). I don’t feel comfortable about this. I don’t feel like he gets proper ICU care. I believe he’s being neglected. 

Please help.”

Thank you, Shelly for writing in and I’m very sorry to hear what you’re experiencing there. Well, if they wanted a signature from you for chest drains on March 3rd, and they didn’t do them until March 6th, then that is certainly negligence. 

I’m not surprised that he’s got an infection. I’ll tell you why. The reason they wanted to do chest drains is simply, he probably had a pleural effusion, and that’s why they needed to do chest drains.

Now, because he had a pleural effusion or he might still have a pleural effusion that’s limiting the compliance of the lungs, which means the lungs can’t expand, can’t exchange oxygen and carbon dioxide, increasing the risk of an infection of a chest infection/pneumonia. No surprise, he needed a tracheostomy.

So, let’s just take the best-case scenario here. Let’s just say that they would have done the chest drains as quickly as possible as you signed the documents. By now, the pleural effusions might have been drained and there would have been a higher chance of him getting extubated, i.e., removal from the breathing tube, avoiding the tracheostomy and avoiding the PEG tube.

With him having a tracheostomy and a PEG tube, now they’re trying to push for a LTAC, which will be a disaster. I made countless videos about LTACs and the danger of letting your loved one going into an LTAC. But I’ve made a video about 10 reasons why LTACs in the US are a scam and I’ll encourage you to watch that video. I will put the link below this video.

So again, whoever’s watching this, when you have a loved one on a ventilator with a breathing tube, your goal is to get your loved one off that ventilator as quickly as possible. That must be your goal. So, by you not giving, by you not pushing for that, this is what can happen. Also, by you not getting a second opinion here, Shelly, by you not having access to the medical record. By getting a second opinion, this could have been avoided. If you engage a service like ours, we can give you a second opinion pretty quickly. We can point out to you what needs to happen very quickly.

Obviously, there have been delays and that’s negligence. I argue that doing a chest drain on the 3rd could have preempted him having a tracheostomy, him having a PEG tube. So, picture this, your husband being extubated, breathing by himself, breathing spontaneously, and then going back to normality as quickly as possible, and now he’s got a tracheostomy and a PEG tube instead.

Here’s another tip. If you are in a similar situation, do not give consent to a PEG tube in a situation like that. You may need to give consent to a tracheostomy. If your family member can’t come off the ventilator, then a tracheostomy would be okay, but a PEG tube is not okay. A nasogastric tube will do perfectly fine. The nasogastric tube is not a surgical procedure, and there is no need for a surgical procedure because the nasogastric tube will do absolutely fine. Also, the longer he’s ventilated, the higher the chances he’s ending up with a ventilator associated pneumonia.

Once again, the goal needs to be to wean someone off the ventilator as quickly as possible and avoiding the tracheostomy. Get rid of opiates, get rid of sedatives as quickly as possible, that must always be the goal. The longer someone is sedated, on opiates, the higher chances patients get deconditioned. You’re right, you probably didn’t get proper ICU care. Why was there a delay to do the chest drains? 

Staffing levels in most ICUs in this day and age, whether it’s doctors or nurses are pretty low because a lot of highly skilled professionals have left the profession since COVID (Coronavirus disease), and ICUs are chronically short-staffed. Again, this is insider knowledge.

I have worked in critical care nursing for 25 years in three different countries, where I worked as a nurse manager for over 5 years in critical care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that if you go to our intensivecarehotline.com testimonial section at intensivecarehotline.com or if you go to intensivecarehotline.com podcast section where we have done client interviews.

Just quickly finishing up the email from Shelly. Other questions here are, is he on inotropes? Vasopressors? What else is going on that you haven’t even shared?

The biggest challenge for families in intensive care is simply that you don’t know what you don’t know. You don’t know what to look for. You don’t know what questions to ask. You don’t know your rights. You don’t know how to manage doctors and nurses in intensive care because we can already very easily say from your email that he’s not a candidate for LTAC. He’ll bounce back to ICU in no time.

So, you will need a second opinion here. Also, you have not mentioned. Is there a cardiologist involved? What’s happening to his heart? What specialists are involved? All the issues with his heart need to be sorted out before he’s going anywhere. But on a ventilator with the tracheostomy, he can’t go to an LTAC. It’ll be a disaster zone for him. He’s at much higher risk of dying in an LTAC than in an ICU.

You’re right that you don’t feel comfortable, but that’s why you need a second opinion. You need handholding and guidance when you have a loved one critically ill in intensive care. So many families come to us when it’s too late, or when we could have turned around, this situation way back when. We can turn around situations pretty quickly because our advice here is absolutely life changing. 

Because it’s life changing, that’s why I also offer one on one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever meeting works best for you. You can join a growing number of members and clients that we have helped over the years to improve their lives instantly by making sure they make informed decisions, have peace of mind, control, power, and influence, making sure their loved ones get best care and treatment always. 

That’s why our advice is life changing, and that’s why I talk to you and your families directly as part of my one-on-one consulting and advocacy. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly on your behalf, which is why how those situations could have been avoided, like we discussed today. If I talk to doctors and nurses directly, I hold them accountable and I turn situations around very quickly because the intensive care team needs to know that you have someone on your team who understands intensive care inside out to ask the right questions. When I talk to doctors and nurses directly with you or on your behalf, 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 so that you have strong advocacy and clinical representation in family meetings with intensive care teams. 

We also do medical record reviews in real time so that you can have a second opinion 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.

We also have a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you click on the membership link, 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. In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded, and all of that will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always.

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.

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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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