Quick Tip for Families in Intensive Care: Why the ICU Might Be Withholding a CT (Computed Tomography) Scan & What to Know If Your Loved One’s in a Coma & Ventilator!

“Why the ICU team might be withholding a CT (Computed tomography) scan and what you need to know if your loved one is in a coma and on a ventilator?”

Hi! My name is Patrik Hutzel from intensivecarehotline.com where we help families of critically ill patients in intensive care to improve their lives instantly so that you can make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

Today, I want to address a question we received from one of our readers, Sarah, and she’s just like you having a loved one critically in in intensive care. So, Sarah writes, “An elderly family member of mine is in a coma in ICU after a brain stroke. He’s in ICU on a ventilator. They did an initial CT scan on arrival, but now the ICU team is saying a repeat CT scan is too dangerous, that moving him could be fatal. They also claimed that even if there’s ongoing bleeding, it wouldn’t change the treatment anyway. What should we do?”

Sarah, this is obviously a critical situation and sadly, not uncommon at all. I’ve worked in critical care nursing in three different countries for over 25 years and I’ve seen it hundreds and hundreds of times.

Let me break this down for you because this is one of those moments where what you don’t know can literally kill your loved one or deprive them of a chance to recover.

Let’s start with the basics. Why was the first CT scan done? When someone has a stroke, especially a suspected brain hemorrhage, which is a brain bleed, any initial CT scan is a standard protocol. It helps to confirm if it’s a bleeding stroke like a hemorrhagic stroke, or a blocked vessel, also known as an ischemic stroke, the size and location of the damage, whether surgical intervention or other therapies are needed. But strokes can unfold very dynamically, bleeding can expand, swelling can worsen, pressure in the skull can rise dangerously. That’s why serial imaging, repeating the CT is often essential to make timely, life-saving decisions.

Now, let’s talk about the ICU’s claim that a CT scan is too dangerous. Here is what I know and hear behind the scenes when ICU teams are saying a CT scan is “too dangerous.” They’re telling you, “We don’t want to move your loved one because it requires too many staff coordination and effort, and we’ve already decided it won’t change our approach anyway.” Let me be blunt. That’s a convenience-based argument, not a patient-centered argument.

Yes, transferring a ventilated critically ill patient to CT carries some risk, but ICU teams routinely move ventilated patients for imaging every single day all around the world when they believe the benefits are worth it. So, you need to look at the real question here, which is why don’t they think it’s worth it? Even if there is ongoing bleeding, it won’t change the care. Really? That’s one of the biggest red flags, and it’s also a myth.

Let me ask you this, if the bleeding has worsened, could that prompt a neurosurgical consult? Could it affect decisions around sedation, anticoagulation, or osmotic therapy? Which means sedation, such as propofol, midazolam, also known as Versed, or Precedex, anticoagulation such as heparin or warfarin, or any other anticoagulation, and osmotic therapy, which could be mannitol for high brain pressures?