Quick tip for families in Intensive care: When should a tracheostomy be done for ARDS?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-when-should-a-tracheostomy-be-done-for-acute-respiratory-distress-syndrome-ards/

Quick tip for families in Intensive care: When should a tracheostomy be done for ARDS?

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

Today’s quick tip is about, “When to do a tracheostomy when someone has ARDS (Acute Respiratory Distress Syndrome)?” So here is the situation, we’re working with a client at the moment in the U.K., who has their 59-year-old mother in intensive care after ARDS, not COVID- induced, not COVID-related, it just came out of nowhere. She was in an induced coma and sedated for around two weeks. She was also paralyzed because they were proning her. And then it took a few days for her to wake up, much longer than the intensive care team would’ve liked it because they were already talking about withdrawing treatment but thankfully the CT (Computed Tomography) scan and the MRI (Magnetic Resonance Imaging) scan of the brain came back. And obviously also with our input to professionally advocate for this lady, a withdrawal of treatment was avoided. Now, as part of this lady’s ARDS, she has some pulmonary fibrosis or some scar tissue in the lungs, which makes it very hard for her to be weaned off the ventilator. She’s currently on 70% of oxygen. Her pressure support is up to 25. Her PEEPs (Positive End-Expiratory Pressure), her inspiratory pressures are very high because of the resistance that has been building up in the lung.

Now, the family wants to know, was there a point in time when a tracheostomy could have been done so that her life can be prolonged? Because at the moment, she’s struggling in getting off the ventilator, if anything, the support is increasing. And the intensive care team gets very vague with an answer and doesn’t want to release medical records.

Now, again, wherever you are, U.S., U.K., Australia, New Zealand, South Africa, you have a right to access medical records. It’s not a privilege. And it makes you wonder, why can’t the intensive care team release medical records? What is it that they have to hide? And we see that over and over again, that intensive care teams delay releasing medical records because they have things to hide because the chances are, that a tracheostomy could have properly been done early on in this lady’s journey. And that means her life could be prolonged now, and at least she could be looking at services like Intensive Care at Home. If she is not going to survive, at least she could go home and spend some time at home with her family and our service Intensive Care at Home.

So, that is my quick tip for today.

Also, again, accessing medical records is a right, not a privilege. And you should make some noise if you can’t access medical records. What is it that they have to hide? And again, in 2022, it shouldn’t be about copying paper-based notes. It should be about giving access to a website with a username and a password, and the medical records should be there because most of it now is electronic, and in the cloud, anyway. So, what is it that they have to hide? And that’s what you have to ask yourself if you have a loved one in intensive care.

Now, if you have a loved one in intensive care, go to intensivecarehotline.com. 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 .

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