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Today’s article is about, “Quick Tip for Families in ICU: My Sister Had a Cardiac Arrest and Hypoxic Brain Injury, Is It Possible She'll Never Wake Up?”

You may also watch the video here on our website https://intensivecarehotline.com/blog/quick-tip-for-families-in-icu-my-sister-had-a-cardiac-arrest-and-hypoxic-brain-injury-is-it-possible-shell-never-wake-up/ or you can continue reading the article below.

Quick Tip for Families in ICU: My Sister Had a Cardiac Arrest and Hypoxic Brain Injury, Is It Possible She'll Never Wake Up?

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

Today, I have an email from Anna who says, 

“Hi Patrik, 

My sister is in a coma. I was told that her sedation ended a few days ago. However, my sister is still on seizure medications which include Keppra, Vimpat, and Valproate. One of the doctors says that my sister’s brain waves are slow on the EEG like in a sleep state. I spoke to another doctor who says that sedation can slow down brain waves. My sister’s overnight nurse informed me that my sister has gag reflexes, cornea reflexes, and the cough. She also flickers her eyes. The night nurse also stated that my sister appeared to be trying to awaken from the coma. However, the day chief nurse said that she saw nothing.

When I asked about the medication that my sister was given, the day nurse stated that my sister was given three seizure medications. My sister woke up every day after her cardiac arrest until she was given seizure medications. The one doctor who was supportive stated that it takes longer for dialysis patients to filter drugs because he has been off duty and the doctor who’s covering him is bad.

My sister’s CT scans came back normal every time; however, her EEG (electroencephalography) reveals sluggish brain waves.  According to the ICU doctor, because she has not awakened, she is in a vegetative state. I told the ICU doctor that the night nurse said that my sister tried to wake up, but she also said that it didn’t mean anything.

My sister woke up days after the cardiac arrest but after taking seizure medications, she has not woken up. Is it possible for a person never to awaken from a coma? I spoke to a surgeon, and he told my mom that my sister was sedated. By the way, my sister flickers her eyes when I talk to her. She also positions her leg in the way she wants.

Now, my sister went in for surgery for dialysis and she went into cardiac arrest on the 26th last month. It took 8 minutes to resuscitate.” 

So, this is a member we worked with last year, and I will read out how we advise the member so you can see what you can get when you are becoming a member for our membership for families of critically ill patients in intensive care at intensivecarehotline.com. 

“It is interesting to know that my sister woke up every day after her cardiac arrest until she was given the anti-seizure medications. The one doctor who was supportive stated that it takes longer for dialysis patients to filter drugs because he has been off duty and the doctor who’s covering him is bad. My sister’s CT (Computed Tomography) scans came back to normal every single time; however, her EEG reveals sluggish brain waves. My question is, is it possible for a person never to awaken from a coma? I spoke to a surgeon who told my mom that my sister was still sedated. By the way, my sister flickers her eyes when I talk to her and I’m wondering when she will wake up.”

All right, here’s our response to Anna’s email.

“Thank you so much for sharing with us your sister’s clinic information.

You mentioned that her sedation ended a few days ago, and she’s still on the seizure medications which include Keppra, Vimpat, and Valproate. EEG findings show brain waves in a sleep state which may be due to her anticonvulsant medications and her recent sedations. Sedation can indeed slow brain waves.

The presence of gag reflexes, corneal reflexes, cough and flickering of eyes, are all positive signs that show responsiveness. The night nurse even mentioned that she appeared to be trying to awaken from the coma while the day nurse has not seen that, and this means that you’ll see some minor variations of her level of consciousness across the day.

One important thing to note here is that your sister is waking up every day after a cardiac arrest until she was given seizure medications. It is important to have a neurologist’s input here as to how they will manage her condition from a neurological point of view.

If the CT scans came back to normal every time, it is best that we can see the official results of a head CT scans and brain MRI (Magnetic Resonance Imaging).”

This is something we always recommend. You need to get access to the medical records so we can look at them and give you a second opinion.

“You are asking: Is it possible for a person to never awaken from a coma? 

When a person is in a coma, the outcome and whether they will awaken depends significantly on the cause, severity, and location of the brain injury. Comas can result from various factors, including brain injuries, strokes, brain tumors, sedation-related or induced coma, or illnesses that affect the brain, like diabetes or an infection.

Based on the details you have shared about your sister showed positive signs. As I’ve mentioned, the presence of a gag reflexes, cornea reflex, and cough, along with eye flickering and leg positioning, suggests that there is a level of brain function and responsiveness.

Your sister showed signs of waking up before starting the seizure medications, Keppra, Vimpat, and Valproate which have sedative effects and can alter her level of consciousness. In addition, her sedation has ended recently. These medications, especially in someone who has kidney issues and needs dialysis, can stay in the body longer and might make it harder for her to wake up. The slow brain waves seen on the EEG, which is a brain activity test, suggest she’s in a very deep state of sleep, and it may be due to these medications.

Please also see some articles on our website:

WHAT IS AN INDUCED COMA AND WHY IS MY CRITICALLY ILL LOVED ONE IN AN INDUCED COMA? I’ll link to those articles in the written version of this video.

HOW LONG DOES IT TAKE TO WAKE UP AFTER AN INDUCED COMA?

In addition, to better understand your sister’s condition, here are some questions and more clinical information we need to gather:

1.) What is her diagnosis?

2.) What is her GCS (Glasgow coma scale)? 

GCS is a neurological assessment tool for assessing the consciousness level of any patient, allowing us to understand her current neurological condition. 

3.) What sedatives and opioids is she on? If she’s on any, what’s the dosage? For more information about sedation, you can click on this link below.

4.) What are the series of her current vital signs including her heart rate, oxygen saturation, breathing rate, temperature, blood pressure, and weight? You can send us pictures of her bedside monitors.

5.) Is she consistently in a normal heart rhythm, also known as sinus rhythm and that’s the preferred rhythm or is she on in an irregular rhythm such as atrial fibrillation or any other irregular rhythms?

6.) Is she on norepinephrine/Levophed or other inotropes/vasopressors? If yes, what’s the dosage? 

7.) What is her current ventilator setting? What ventilator mode is she on? What are their plans for weaning off the ventilation? 

8.) Any result of the latest arterial blood gases (ABG) or chest x-rays? It would be very helpful, again, to help more about assessing your sister’s current situation. 

9.) All blood results would be helpful.

10.) Any other diagnostics like head CT scan, brain MRI scan etc?

11.) What medications is she on? We need a full list of it.

12.) Is she currently on nasogastric tube feeds? What are they giving for her nutrition? Is she opening bowels? Is she absorbing feeds?

13.) Is she making spontaneous urine on top of her being on dialysis? What’s her fluid balance like over a 24-hour period?”

So, I hope that helps and answers your question.

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 intensive 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 with our consulting and advocacy. You can verify that at intensivecarehotline.com if you go on our testimonial section, click on the link there, or if you watch our intensivecarehotline.com podcast where we have done client interviews who can verify the work that we’ve done for them and their family.

Because of all the questions and the need that is out there, that’s why we created a membership for families of critically ill patients in intensive care. You can become a member, and you can get value by us evaluating your clinical information, and by giving you a second opinion. You can get access to the membership 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 eBooks and 21 videos that I’ve personally written and recorded. 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.

We have helped hundreds of members and clients over the years. Once again, check out our testimonial section and our intensivecarehotline.com podcast with client interviews.

I also do one-on-one consulting and advocacy over the phone, Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. I also talk to doctors and nurses directly. 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 with intensive care teams.

We also do medical record reviews in real time so that you can get 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. 

All of that you get at intensivecarehotline.com. Call 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, comment below what you want to see next, what questions and insights you have from this video, and share this video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on a show and you will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to my intensivecarehotline.com 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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