Hypoxic brain injury after drug overdose&cardiac arrest,ICU wants to "pull the plug" on our daughter

1 year ago
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https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-hypoxic-brain-injury-after-drug-overdose-cardiac-arrest-icu-wants-to-pull-the-plug-on-our-daughter/

Quick Tip for Families in Intensive Care: Hypoxic brain injury after drug overdose & cardiac arrest, ICU wants to "pull the plug" on our daughter

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

So, we’re currently working with a client who has their 36-year-old daughter in ICU after drug overdose, after cardiac arrest, and potentially hypoxic brain injury. And it’s only been day three or day four, since the cardiac arrest and the potential hypoxic brain injury, which apparently was confirmed in an MRI (Magnetic Resonance Imaging) of the brain.

Now, she was in cooling therapy for a couple of days and she had seizures and now she’s still on sedation. And now they’re already talking about, that she will never wake up. And that she will have permanent brain damage and that she will be dependent on 24-hour care for the rest of her life. And whether the family wouldn’t want to withdraw treatment because it’s “not in their daughter’s best interest” to live.

It’s only been day four, they haven’t even woken her up after sedation, because usually what happens is when you wake someone up, you want to know how quickly they can wake up and what’s their response going to be? Are they responding at all? Can they obey commands? Can they open their eyes? Can they squeeze hands? Can they sit up? Those are all unanswered questions. And sometimes that can take days, weeks, potentially months. So it’s very hard to predict the future.

I certainly can’t predict the future and neither can the ICU team. And there are plenty of people living in the community that have got a brain injury, but they still feel it’s worthwhile living for them. And their life is still meaningful for them. So, it’s very early days. ICUs throwing out the baby with a bath water without even having woken her up and seeing what’s actually going to happen. And seeing whether the MRIs actually confirmed by what this lady will be doing.

The other option for a patient like this, is obviously a tracheostomy to give this lady time if she can’t be extubated, maybe she can be extubated. I think chances are fairly slim. She probably will need a tracheostomy, but end-of-life for a 36-year-old lady is probably not an option and should never be considered unless, you know what’s exactly happening unless, you know she doesn’t want to live. She doesn’t wake up. Maybe she’s got a Glasgow Coma Scale of 3. But those are all unanswered questions and can only be answered after the sedation has been switched off, after seizures have been controlled probably with Keppra or phenytoin. And then only then can you make an accurate assessment of what’s going to happen next and how you should proceed.

So, three or four days in ICU, not a long time, even three or four weeks in ICU is not a long time in situations like that.

So that’s my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com and call us on one of the numbers on the top of our website, or simply send us an email to support@intensivecarehotline.com.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org.

And if you need a medical record review for your loved one in ICU or after intensive care, please contact us as well. We can help you with that.

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