Cardiac Arrest: Hello, My husband had a... - ICUsteps

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Cardiac Arrest

drswigley profile image
18 Replies

Hello,

My husband had a cardiac arrest on 7/16/22. We were on our way to the urgent care due to shortness of breath,just as we were pulling into the lot, he went into full arrest.D rs at urgent care started CPR, shocks immediately , which lasted appx 5 min until ems arrived, performed CPR, and also admin oxygen ...he did not have ROSC until 36 min after starting CPR. He had a stent and a balloon pump, He has been heavily sedated and on a ventilator ever since, because of his extreme aggression when weaning off the medicine . They have switched him to a trache tube and started Seroquel for agitation a few days ago, but he's still in a blind rage when he starts to wake up,and has to be in point 4 restraints. His MRI shows very minimal damage but the Drs can't assess his nuerological status because he is completely unaware, but violent when he starts to wake up...I am just wondering how they're ever going to get him awake without him being so agitated and aggressive. If anyone has any suggestions or stories, please share

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FamilyHistorian profile image
FamilyHistorian

Coming out of a coma can be really difficult. It’s not like what is shown in films. Following double pneumonia, sepsis and open heart surgery (replacement aortic valve) and my family being told I wouldn’t make (twice) it took me nearly 2 months to come out. This was despite attempts to reduce the sedation. A t one stage they put mitts on my hands to try and stop me pulling my tubes and hitting out at the staff. If it’s any consolation I didn’t know what I was doing it was my family who went through the trauma. I had a tracky and I had hallucinations.Whilst I am sure your are worried about your husband you really must take care of yourselves at this difficult time.

drswigley profile image
drswigley in reply to FamilyHistorian

Thank you, your story gives me much needed hope right now. They did put the mitts on him too, but I insisted they remove them so I could hold his hands. I didn't see the point since he was restrained. When the sedation is lifted just a tad, he tries to wriggle out of the restraints and scoots as far as he can down the bed and then jerks his trache tube loose. It's like he's in a nightmare that he's being held captive and is trying to escape! He dislocated his shoulder yesterday! No recognition or awareness, just straight survival panic mode. I have been staying with him from sun up to sun down for 16 days now, but I am going to take your advice and take care of myself too. I am trying to accept that, right now, my presence is not helping matters when I become anxious too! One of the hardest parts is trying to give other family members and friends an update on his status, trying to explain what is happening and how he can be violent but not even coherent. Thank you for the hope that it can get better!

stevet11753 profile image
stevet11753 in reply to drswigley

Dreaming of being held captive is a common experience when heavily sedated. I was held captive in a bistro bar (!) by gangsters who wanted to kill me. I kept escaping and going on the run but was always recaptured. Hopefully your husband will start to recover soon.

FamilyHistorian profile image
FamilyHistorian in reply to drswigley

I too was kidnapped

You need to be aware that he may say some unpleasant things to you including "go away". He won't mean it - just doesn't know! He may make allegations about his care. This can be difficult as it may be true but more tan likely not. I was very suspicious about some staff. He is clearly suffering from delerium.

My wife couldn't cope with keeping every one informed so one of the girls took on keeping family update and because I belong to a couple of organisations they nominated one person to keep in touch.

When I stepped down from ICU the hospital care changed from one to one to many to one. My wife used to arrive at about 1030 and she would spend over an hour helping me in the bath room and also making sure I did my physio. The nursing staff just diddn't have the time!!

drswigley profile image
drswigley in reply to FamilyHistorian

Thank you! I appreciate your stories and advice very much ❤️

xEmmax123 profile image
xEmmax123

From what I know and experienced they will continue to do sedation breaks until he stops being so agitated, it will eventually stop, my dad was on sedation and ventilator for 8 days before he was off completely, the agitation still continues but not as bad.

drswigley profile image
drswigley in reply to xEmmax123

Thank you, that's encouraging...after 14 attempts of lifting the sedation then going even higher to get him to calm down again,it's so hard to see that it will get better.

xEmmax123 profile image
xEmmax123 in reply to drswigley

Yes I know exactly what ur going through, they had to put the sedation up for my dad also and just did sedation break every day and it's just like a weaning process they will lower it at some point and eventually he should come round more and more, my dad had his cardiac arrest on the 11th July he's still in hospital not really recognising who we are but nurses are saying it will eventually come. Rehab is a big help when he gets there. It will be a long process and patience is they key but very horrible to see.I hope he gets off sedation soon and fingers crossed he will be OK. Look after ur self also.

drswigley profile image
drswigley in reply to xEmmax123

Thank you! You as well!

Hi. I was sedated for about 5 weeks when I caught covid in summer of 2020. I was on a ventilator and then had a trachy. I had ICU delerium, living in a parallel world. Often violent dreams, involving nurses or hospital settings. I read in my notes that on one occassion I tried to get out of bed, and I know there was one dream where I tried to get out of bed because I thought the nurses were going to kill me. When I woke up from the sedation it took a bit of time to realise where I was and it was not until my nurse assured me that I had been in the hospital all the time and not in France, Cyprus, Scotland and that the memories I had had just been nightmares. I was given an anxiety tablet for the rest of my time in care but once home my gp advised not to take any longer. The dreams stopped once I spoke with the nurse. The memories are still vivid, but I am not haunted by them. It helped to get my notes so I could see what happened during my hospital stay. ICU Delerium is very common.

drswigley profile image
drswigley in reply to

Thank you. It's very scary and I worry what he might be going through now, as well as the long term affects.

in reply to drswigley

Yes I am sure it is worrying. Some patients suffer PTSD. I did have a follow up with the ICU pschologist, but think my ICU nurse's comforting words were enough to clear most of the anxiety.

drswigley profile image
drswigley in reply to

That's good, I'm happy you had such great care! I'm very confident that all of the nurses (with maybe one exception) are extremely patient and try talking to him when he starts moving around. I am trying to remain calm around him as well, which is hard because I just want to wake him out of this horrible nightmare he's in! Your outcome is very encouraging, I hope you continue to do well!

in reply to drswigley

Thank you. I hope your husband recovers soon.

Sepsur profile image
Sepsur

It’s a question of trial and error, the right type & amount of sedation & its reduction to create a less reactive reaction.

Sounds like he may be suffering quite extreme hyperactive delirium.

drswigley profile image
drswigley in reply to Sepsur

Thank you. Yes, they have tried many combinations and strengths. The antipsychotic dose was doubled yesterday, so I'm hoping that helps on the next sedation wean today! I'm really hoping that they will find it soon! Also worry about psychological affects this continued delirium will have.

Kit10 profile image
Kit10

It is very common for ICU patients to have strange vivid drug-induced dreams/hallucinations (I certainly did), and if you only knew what your husband is dreaming his behaviour might make perfect sense. I really hope he can be woken up and reassured as soon as possible. If he half wakes and finds himself restrained it is likely to be terrifying for him.

Something you could do that might be helpful for when your husband wakes up is to keep a diary of everything that happens. If he says anything, even if it's weird, write that down too. The nurses may be keeping a diary but they probably won't record that sort of thing. When he wakes he may have very clear memories of his dreams but struggle to know what really happened and what was imaginary. Talking through what really happened with him could be a big help sorting it out in his mind.

He may need to do a lot of talking. So may you. Do look after yourself.

Being calm and reassuring, even if you're not sure he can hear, is probably the best thing you can do right now. He may remain disoriented and short tempered for a while, even after the sedation has been stopped.

Sadly the wards patients get transferred to after ICU often have staff who are less understanding of ICU experience. Hospital staff, understandably, can get very defensive in response to even raised voices from patients. If they get shouty and scold him about "unacceptable behaviour" it will only escalate the situation. I hope they are more understanding than that in your hospital.

The other advice I've read that might help, once he is awake, talk to him about real things going on outside in the world to help him reconnect with reality - time, date, seasons, weather, news (yes, I know that may not be the happiest subject...), family and friends' news, etc etc I was in ICU in covid lockdown and had no visitors, so I don't now how good it would have been.

I wish you both all the best.

drswigley profile image
drswigley in reply to Kit10

Thank you!

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