Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where
we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our
readers and the question last week was PART 1 of
“MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART 1)”
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer PART 2 from Heather who’s
partner remained in Intensive Care on the ventilator.
So, today I answer PART 2 of
MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART2)
Heather from the USA writes
Hi Patrik,
Thank you so much for the help. I wanted a little more advice. My partner only had one failed extubation and the empyema had not been diagnosed and treated and the antibiotics for the pneumonia had been stopped.
He had surgery for the empyema, which the surgeon has signed off the case and the pneumonia is getting better and he coughs good and
all.
I told the doctor yesterday that I would like them to trial extubate him. They did a spontaneous breathing trial.
I was
with him and he passed the trial, normally it's 30 minutes. He was breathing for 2 and a half hours and his blood pressure stayed good the whole time and they did give him some Midazolam while doing the breathing trial and he did well.
However they still wouldn't extubate.
He did a trial today before I got there and he was on the breathing trial for 20 mins and his blood pressure got high.
They have significantly cut his pain meds
and sedation today his Blood Pressure is ok but he's trying to work that tube out of his mouth.
I feel like no matter how well he does, it’s not good enough and it’s almost like they’re trying to break his spirit.
I hope to get some more insights from you.
Thanks
Heather
Dear Heather,
just by what you are describing, they need to extubate him.
The reason his blood pressure is up is because he's agitated. They need to take his tube out.
If he's passing all the trials, there is no reason why he can't have the tube out!
Why are they so adamant and not extubate?
They need to give you a specific reason, which they haven't given you!
The longer this goes on, the higher the chances that he'll have the tracheostomy.
You need to be very clear and start to manage
the Intensive Care team! Demand what you know is right for your partner and nothing less!!
Stop buying into the Intensive Care team's "perceived power" and "perceived authority"!
Do they want to earn some money by putting in a tracheostomy? Do they want to keep him in ICU to occupy an expensive bed long term?
You need to get comfortable with challenging the Intensive Care team and
even he fails the extubation(which it sounds like he won't) they can then do the tracheostomy.
Also, keep in mind that they may want to enrol your partner in a medical research study or he is already in one and they wouldn't tell you.
It sounds
to me like there are things happening "BEHIND THE SCENES" that may lead them to decide against extubation and they won't share with you their"hidden agenda"
Recommended resources
Let me know if you get stuck and I can guide you further.
Thank you& Kind Regards
Patrik
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