My mom had cardiac arrest and is in ICU,has brain damage and is not “waking up”, what should we do?

Patrik Hutzel
31 Aug 201617:22
EducationalLearning
32 Likes 10 Comments

TLDRIn this episode of 'Your Questions Answered', Patrick Hudson addresses Malek's concern about his 79-year-old mother who suffered a cardiac arrest following a heart attack and is now in a critical condition with irreversible brain damage. Patrick explains the gravity of the situation, the likelihood of end-of-life scenario, and advises Malek on how to navigate the intensive care process, ensuring his mother's comfort and making informed decisions about her care.

Takeaways
  • 🌟 Intensive care situations can be complex and emotional, requiring informed decisions and understanding of medical language.
  • 🏥 The patient's family should seek to gain control and influence over the decision-making process in intensive care.
  • 💡 In cases of cardiac arrest and heart attacks, timely intervention is crucial to prevent irreversible organ damage.
  • 🧠 Brain damage following cardiac arrest can be severe, and tests like MRI and EEG can confirm the extent of the damage.
  • 🩺 The intensive care team's recommendations, including the withdrawal of life support, should be carefully considered by the family.
  • 🕊️ End-of-life situations in intensive care require a sensitive approach, allowing the family to prepare and say goodbye.
  • 🤝 It's important for the family to advocate for the patient's comfort and to be involved in discussions about life support removal.
  • 📚 Understanding the medical procedures and potential competing interests in intensive care can empower the family.
  • 🌐 Access to resources, such as blogs and counseling services, can provide additional support and guidance for families in intensive care.
  • 📈 The family should be aware of the potential need to make quick decisions and should be prepared to do so in the best interest of the patient.
  • 💌 Patrick Hudson from Intensive Care at Lancome offers support and guidance through his counseling and consulting services.
Q & A

  • What is the primary goal of the Intensive Care at Lancome?

    -The primary goal of Intensive Care at Lancome is to improve the lives for families of critically ill patients in intensive care, providing them with the ability to make informed decisions, have peace of mind, and gain real control and influence over the situation.

  • What was the situation described by the reader last week?

    -Last week's situation involved a reader whose 62-year-old husband passed away in intensive care after cardiac arrest. The intensive care team withdrew treatment against the reader's will, leading to the question of whether the husband could have been saved.

  • What is the question Malek is seeking advice on?

    -Malek's question is about his 79-year-old mother who went into cardiac arrest after a heart attack and has been in intensive care for a week with confirmed heavy brain damage. He is seeking guidance on what to do next as the doctors have indicated there is no hope for recovery.

  • What does 'heavy brain damage' imply in Malek's mother's case?

    -In Malek's mother's case, 'heavy brain damage' means that she is unresponsive to stimuli, her pupils are dilated and non-responsive to light, and she cannot breathe without a ventilator. This is due to the lack of oxygenated blood delivered to the brain during the cardiac arrest and resuscitation process.

  • What is the significance of the 18-minute resuscitation time for Malek's mother?

    -The 18-minute resuscitation time is significant because it indicates a high likelihood of irreversible brain damage due to the lack of cardiac output and oxygen supply to the brain during that period. The longer the downtime, the higher the risk of significant organ damage, especially to the brain.

  • What does the intensive care team's recommendation of not performing a tracheostomy mean?

    -The recommendation of not performing a tracheostomy implies that the intensive care team believes further invasive procedures would not improve the patient's condition and is suggesting to let nature take its course, indicating that they view the situation as an end-of-life scenario.

  • What are the implications of Malek's mother being taken off sedation and not responding?

    -The fact that Malek's mother is not responding after being taken off sedation indicates that she is in a natural coma due to the irreversible brain damage. This suggests that the chances of recovery are minimal, and the focus should be on ensuring her comfort and preparing for the end of life.

  • What is the importance of the family's involvement in decision-making during end-of-life situations?

    -Family involvement in end-of-life decisions is crucial for ensuring that the patient's wishes and the family's needs are respected. It allows the family to have a say in the timing and manner of the withdrawal of life support, and to ensure that the patient is not subjected to unnecessary suffering or prolongation of life against their wishes.

  • What should Malek and his family consider when preparing for the removal of life support?

    -Malek and his family should consider the timing that feels comfortable for them, ensuring that they have enough time to say goodbye and fulfill any spiritual, religious, or cultural needs. They should also ensure that the patient is not suffering and that the process is cooperative and amicable, avoiding any pressure from the intensive care team.

  • How can one gain more control and influence in intensive care situations?

    -One can gain more control and influence by educating themselves on intensive care processes, learning the 'secret language' of intensive care, understanding the competing interests involved, and asking the right questions to medical professionals. This knowledge empowers families to make informed decisions and advocate effectively for their loved ones.

  • What resources are available for those seeking guidance in intensive care situations?

    -Resources include a free instant impact report, blog posts with tips and strategies, ebooks, videos, and audio recordings. Additionally, one-on-one counseling and consulting services are available via Skype, phone, or email through Intensive Care at Lancome.

Outlines
00:00
🏥 Introduction to Intensive Care Support and Last Week's Question

Patrick Hudson introduces himself as a support figure for families with critically ill patients in intensive care at Lancome. He emphasizes the importance of making informed decisions and having control over the situation. He reviews a previous episode where a question about a 62-year-old man's death in intensive care was answered and invites viewers to check the response via a link provided. Hudson sets the stage for this week's question, which involves a mother in intensive care after a cardiac arrest and brain damage.

05:02
💔 Addressing a Family's Concerns on Cardiac Arrest and Brain Damage

The video addresses Malek's concern about his 79-year-old mother who suffered a heart attack, went into cardiac arrest, and now has irreversible brain damage. Hudson explains the high likelihood of brain damage due to the lack of cardiac output during resuscitation efforts. He mentions that the intensive care team has likely done their due diligence, including MRI and EEG tests, to diagnose and prognose the situation accurately. Hudson advises Malek and his family to understand the severity of the situation and prepare for the end-of-life care, ensuring that the mother is comfortable and not in pain.

10:04
🛌 Discussing Life Support and End-of-Life Decisions

Hudson continues the discussion on Malek's mother's condition, explaining the implications of the intensive care team's recommendation to not perform a tracheostomy and the potential withdrawal of life support. He describes the process of removing the breathing tube (extubation) and the inotropes used for life-sustaining treatment. Hudson emphasizes the importance of the family being prepared for the mother's likely quick passing after life support is removed and stresses the need for the family to have adequate time to say goodbye, rather than being rushed by the intensive care team's needs.

15:06
📚 Resources for Advocates in Intensive Care

Patrick Hudson concludes the video by offering resources for families to become better advocates for their loved ones in intensive care. He mentions a free instant impact report that can help viewers make informed decisions, gain peace of mind, and exert control in such situations. Hudson also invites viewers to explore the blog section, ebook offerings, and one-on-one counseling for further support. He signs off, promising another update next week and encouraging viewers to reach out with any questions or concerns.

Mindmap
Keywords
💡Intensive Care
Intensive Care refers to a specialized healthcare facility where patients with life-threatening conditions are closely monitored and treated. In the context of the video, it's where critically ill patients, such as Malek's mother, are admitted to receive immediate and intensive medical attention. The video emphasizes the importance of understanding the medical procedures and decisions made within an intensive care unit for families to make informed choices.
💡Cardiac Arrest
A cardiac arrest is a sudden loss of heart function, where the heart stops beating effectively, preventing blood from being pumped to the brain and other vital organs. In the video, Malek's mother experienced a cardiac arrest after a heart attack, which led to her being resuscitated and placed on life support in the ICU. The term is crucial as it sets the stage for the family's dilemma regarding her treatment and prognosis.
💡Brain Damage
Brain damage refers to any harm or injury to the brain that disrupts or alters its normal function. In the video, it is mentioned that Malek's mother has sustained heavy brain damage, as confirmed by an MRI and EEG tests, which has left her unresponsive and unable to breathe without a ventilator. This term is central to understanding the prognosis and the difficult decisions the family faces regarding her care.
💡Ventilator
A ventilator is a machine that helps a patient breathe when they are unable to do so on their own. In the context of the video, Malek's mother relies on a ventilator to breathe because of the brain damage she suffered. The ventilator's role is significant as it represents the life-support measure that the family must consider when making decisions about her care.
💡MRI (Magnetic Resonance Imaging)
MRI is a non-invasive medical imaging technique that uses a magnetic field and radio waves to create detailed images of the internal body structures, including the brain. In the video, an MRI was used to confirm the extent of Malek's mother's brain damage, which is a crucial diagnostic tool in determining her prognosis and treatment options.
💡EEG (Electroencephalogram)
EEG is a diagnostic tool that measures and records electrical activity in the brain through electrodes placed on the scalp. It helps in assessing brain function and identifying abnormalities. In the video, an EEG test was conducted on Malek's mother, which also indicated heavy brain damage, further confirming the grim prognosis provided by the MRI results.
💡Neurologist
A neurologist is a medical specialist who diagnoses and treats conditions related to the nervous system, including the brain and spinal cord. In the video, the involvement of a neurologist is implied since an EEG is typically ordered and interpreted by such a specialist. The neurologist's role is significant as they provide expert input on the brain-related aspects of Malek's mother's condition.
💡Inotropes
Inotropes are drugs that are used to increase blood pressure and strengthen the contractions of the heart muscles. In the context of the video, inotropes are mentioned as part of the life-sustaining treatment Malek's mother is receiving after her cardiac arrest and the subsequent cardiac arrest. The term is important as it relates to the ongoing efforts to support her vital functions and the potential withdrawal of such treatment.
💡End-of-Life Situations
End-of-life situations refer to the period towards the close of a patient's life when they are facing imminent death, and decisions about their care and treatment are made. In the video, the term is used to describe the scenario where Malek and his family are dealing with the realization that his mother's condition is irreversible and decisions about withdrawing life support are being considered.
💡Family Meeting
A family meeting in a healthcare setting is a formal discussion between the medical team and the patient's family to discuss the patient's condition, prognosis, and treatment options. In the video, the term is used to describe the potential meetings that Malek and his family may have with the intensive care team to discuss the difficult decisions regarding his mother's care and the possibility of withdrawing life support.
💡Advocacy
Advocacy in a healthcare context refers to the act of speaking up for and supporting the needs, rights, and well-being of a patient, particularly when the patient is unable to do so themselves. In the video, Patrick Hudson emphasizes the importance of family members becoming advocates for their critically ill loved ones in the ICU, ensuring they make informed decisions and have a say in the care and treatment provided.
Highlights

Patrick Hudson from Intensive Care at Lancome provides support for families of critically ill patients.

The episode aims to help families make informed decisions and gain control during difficult times.

Last week's episode addressed a question about the possibility of saving a 62-year-old man after cardiac arrest in intensive care.

This week's question concerns a 79-year-old woman who suffered cardiac arrest and now has severe brain damage.

The woman has been in ICU for a week, unable to breathe without a ventilator due to brain damage.

Brain damage was confirmed through MRI and EEG testing, with no response to stimuli and dilated pupils.

The intensive care team has removed sedation, and the woman is unresponsive, indicating a natural coma due to irreversible brain damage.

The team is not suggesting a tracheostomy and is referring to a one-way excubation, indicating a likely end-of-life situation.

The family is advised to prepare for the end of life in intensive care, ensuring informed decisions and peace of mind.

The importance of making sure the patient is comfortable and not suffering during the withdrawal of life support is emphasized.

The family should not feel rushed into withdrawing life support and should have time to say goodbye.

The intensive care team may pressure to remove life support quickly due to high demand for ICU beds.

The family should ensure their spiritual, religious, and cultural needs are met during the end-of-life process.

The episode encourages families to become advocates for their loved ones in intensive care, gaining knowledge and influence.

A free Instant Impact Report is offered to help families make informed decisions and gain control in intensive care situations.

The report teaches understanding of intensive care language and navigating the complex environment.

Families can access resources, ebooks, videos, and one-on-one counseling for additional support.

The episode concludes with an offer for further support and the next update in the series.

Transcripts

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IntensiveCareFamilySupportAdvocacyCardiacArrestBrainDamageEnd-of-LifeDecisionMakingMedicalAdviceEmotionalSupportHealthcareCommunication