ICUsteps
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Round 2 Ventilator because of pneumonia in the ICUhttps://healthunlocked.com/

Hi,

We brought my father to the ER 11 days ago because he collapsed in his bedroom. He hit his head hard on his dresser table. He was conscious when we reached him but not able to stand or sit without support. He was slurring all his words and unable to to tell us what day it was etc. We called the paramedics and the said his vitals were good but took him in because of the disorientation, slurring an instability. At the ER he had a cat scan which came back clear. No stroke activity of bleeds. He suddenly became very agitated and started to rip the IVs etc out. The staff had to put him in restraints. He fought against the restraints and did not settle down. They gave him ativan and he still fought. Eventually he resisted less and they decided to keep him overnight for observation. He was agitated and still fighting the restraints in observation. They gave him a dose of Haldol because he was so aggressive. While a nurse was inserting an IV that had come out in the struggle he went into V-fib (Cardiac arrest) They started compressions immediately and shocked him 3 times to bring his heart back in rhythm. He was then moved to ICU and intubated. He was given an echocardiogram which came back saying his heart was only working 20-25%. He was sedated and on the ventilator for 6-7 days and they tried to wean him off several times. On the 6th or 7th day he was able to breathe with a mask. He slowly came out of the sedation, but it took 24-36 hrs for him to become alert and communicate. There was no brain damage detected on his MRI or cat-scan after the v-fib. While on the mask he developed pneumonia. He became agitated and restless off sedation. At one point he began to hyperventilate and his oxygen plummeted. Due to low oxygen and severe agitation (he wouldn't let them suction out the mucous, kept his lips pursed) the sedated and intubated him again. They just completed another echo and it came back that his heart was now working 55-60% (which is in the low normal range) He still has pneumonia and a 101.4 fever. I was disappointed he needed to go back on the tube, but understand. Maybe it is a good thing that he is so sedated because he is so agitated and keeps trying to get out of bed or pull out his tubes. The staff and his family cannot rationalize with him that this is for his own good or settle him down, Anyone else have experience with this type of severe agitation / anxiety?????

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Hi,

My dadwas rushed to ICU after a big internal bleed, sedated, etc. In total he was sedated for quite a while, 2 weeks maybe. He had awful delirium and reacted terribly to coming off the sedation. They ended up having to try four different types on him (including an 'expensive' one that usually helps people to wake up nice and calmly when they're weaned from it...it didn't work on my dad though!) He was pulling at everything, incredibly confused etc. It's horrible to see and really scary for him. In the end it was just a waiting game - they had to keep weaning him until his reactions were lessened slightly. It took a long run but he is now at home with us and mentally completely back to his old self. Not sure where you are located but could you perhaps ask them if they could try another sedation on your dad that might help him wake more calmly? They also gave my dad haloperidol to calm him because they needed to wean him. Hope everything goes well for you guys, and I'm really happy for you that his brain scan came back clear. All the best!

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Thank you so much for sharing your experience! My dad has what one would call a "difficult" personality to begin with. He is pretty feisty for an old man so I am not surprised he is so restless and agitated (even on the sedation). Its just the ICU nurses and Dr.s who keep telling us he should have calmed down by now......so of course we worry. It helps to hear your dad was a "fighter" too.

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My dad is very impatient, used to being up and about, and the thing he hates most is being still and being told what to do! The doctors and nurses kept telling us that he should have been responding/coming round quicker (they took him for a brain scan at one point even though his illness didn't really have the potential to lead to a brain injury) because it took him so long and he was SO agitated...for a week at least. He had to wear the mitts, they had to keep sedating him etc. But he came round eventually and he's doing brilliantly now. It's scary when they're telling you that they should be doing something and they're not, but it really does take different people different amounts of time to come through, and some react a lot more to sedation than others. My dad also wouldn't let them suction! He told us that although he can't remember hardly any of his ITU stay (4 weeks in total), he remembers feeling like the nurses and doctors were trying to tell us that he was deranged and he was trying to get across to us that he wasn't. Do you feel like your dad is 'himself' even when he's agitated?

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Oh yes. And he does suffer from anxiety so I’m sure that contributes to it. But the ICU staff have so many different people / personalities to navigate!! One is positive the next one can seem negative

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