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

So, currently we are working with a client who has a 36-year-old brother in ICU after cardiac arrest and hypoxic brain injury. The intensive care team was adamant in the beginning that they should just extubate the patient, remove the breathing tube, and let him die because he’s “not having any future perceived quality of life.” Again, that’s just a perception. The family was adamant not to go ahead with that because they wanted to give him a chance. It was only Day 8 in ICU which is not a long time.

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

Coming back to our client that we’re currently working with, so obviously, we advised the family not to agree to any withdrawal of treatment. Like I said, it’s all about putting things in perspective, eight days in ICU is not a long time. You can always reassess after maybe eight weeks, maybe after eight months. What’s the rush to kill someone in ICU? It’s a relevant question, and it’s a question that we need to ask in this current environment. 

So, cutting a long story short, now the client is actually waking up. Initially, his Glasgow Coma Scale was a 3, which means he was not responsive, he wasn’t breathing. Now, his Glasgow Coma Scale has improved, it’s probably more of a 6 to 7 now. He’s moving his arms, he’s thrashing around, he’s not awake yet but he’s opening eyes, he’s breathing spontaneously on CPAP (continuous positive airway pressure) and pressure support, which means he’s moving closer towards extubation. He’s got a gag reflex, he’s got a cough which means he can most likely protect his airway once he’s extubated, which also means he may not even need a tracheostomy.

The conversation has now shifted from, “Oh, we’re going to extubate a one-way extubation and let him pass away whilst he couldn’t breathe” to “Ok, let’s extubate him. Let’s see how things go and then look at rehabilitation as the next step.” For a 36-year-old man, that should be going without saying. Why are we talking about end of life for a 36-year-old man? Just because the ICU team thinks, “Well, he has no ‘quality of life’,” Also, they were using terms like he has no “meaningful recovery.” What’s meaningful for an ICU team might not be meaningful for the family. It might be very meaningful for the family to let their loved one live and see how things unfold. 

There’s plenty of time to talk about <a href="http://intensivecarehotline.com/blog/the-difference-between-real-and-perceived-end-of-life-situations-when-your-loved-one-is...