Any drs? FIL in ITU on vent

ChiswickFlo · 05/06/2022 19:29

whateveryouwantmetosay · 05/06/2022 19:16

FIL has been coughing dreadfully since March. Initially likely Covid (didn't test, triple vaxxed). He went through two courses of antibiotics, the second one resulting in a much better outcome. He then caught a cold and the cough came back but not as severe. He was in Cornwall earlier this week, breathing was difficult to came back early (London) and went into hospital yesterday. Chest X-ray clear but they admitted him as low oxygen levels.

He took a sudden turn earlier, heart rate at 160 and then intubated him. Now talking about pericarditis and doing a CT scan tomorrow.

Does anyone with any medical knowledge know what might be happening? We live abroad but DH is flying back tomorrow. ITU won't allow visitors for more than an hour and you have to book your time slot...is this typical?

I'm sorry. How worrying.
Yes, I'm afraid the 1 hour pre booked slot is typical here in the UK, even in itu.
It's ridiculous but won't be changing anytime soon.
My mum nearly died in April and having to phone the ward repeatedly to get a slot (from 1pm-7pm) made everything much more stressful.
^ the DofH then stopped the requirement for a negative rapid antigen test prior to visits 🤷‍♀️

Original poster

whateveryouwantmetosay · 06/06/2022 03:56

.

OP posts:

Original poster

whateveryouwantmetosay · 07/06/2022 02:40

So no CT scan today because he's intubated and there's a lot of equipment??? What??

OP posts:

eatyourcrustspls · 07/06/2022 03:09

whateveryouwantmetosay · 07/06/2022 02:40

So no CT scan today because he's intubated and there's a lot of equipment??? What??

Ex-ITU nurse here.

Going to CT is a huge task, not impossible but you need lots of staff. It could be that he's not stable enough to go. He would need to go on to a portable vent & oxygen and the anaesthetist would need to come to CT, plus nurses. It is a huge effort not only done when they are stable.

Like I said, it could be that he's not stable enough to come off the main vent to go on the portable one. Plus if he's on infusions that's a lot to take into account. If he suddenly deteriorated whilst on transfer it is a lot to deal with in a corridor and not safe.

Wishing him a speedy recovery.

Original poster

whateveryouwantmetosay · 07/06/2022 05:23

The doctors are saying his vitals are stable. He's not breathing. The vent is breathing for him. Doctors saying he needs rest. But I'm not there asking the questions. What can I do to find out more that SIL may not be asking or being told? Or would they be telling her more if there was more to say?

OP posts:

eatyourcrustspls · 07/06/2022 09:12

If the vent is doing all the breathing than he may not be as stable as they say he is, despite stable vitals. Normally you would like them to make some kind of respiratory effort but again, it's hard to say without being there as he could be doing some of it and the vent helping him.

They do like a period of calm before taking them to CT as it is like an expedition and can cause them to be a little unsettled.

Unless you are down as a family contact there's not much you can do. Your husband should be able to find out more.

Samarie123 · 07/06/2022 09:26

I'm not a doctor but I find it odd he went straight on a vent instead of an oxygen mask.

Goodskin46 · 07/06/2022 09:50

He took a sudden turn earlier, heart rate at 160 and then intubated him. Now talking about pericarditis and doing a CT scan tomorrow.

This to me suggests a sudden deterioation. My best guess is a pulmonary embolus (PE). Covid does pre dispose to blood clots so I suspect either a PE (clot in lungs) or MI (clots in heart).

Greybeardy · 07/06/2022 13:13

OP, no one on here can really give you the answers you're looking for - the team looking after your FIL will have mountains of information that will be informing their management. Broadly speaking though, moving intubated ICU patients, even relatively stable ones, is a high risk manoeuvre and the benefits of getting the test results have to outweigh the risk of the transfer. In ICU patients the clinical picture can also change quite quickly (and transiently) requiring more or less support & equipment and that may also affect the decision making. Your first post mentions that they think he has pericarditis, which is not usually diagnosed primarily by CT, so if they're reasonably certain that that's the primary problem then the scan may not be the most urgent investigation and there may be a bit more flexibility in the timing.

@Samarie123 there are options for supporting ventilation non-invasively before intubating patients, but sometimes it's so barn door obvious that someone's going to end up on a ventilator that working through the other options is not appropriate or safe.

@Goodskin46 the description of the deterioration is so vague it fits with almost any cause of collapse, including PE/MI. The OP's first post said the team think the problem is pericarditis though, which is usually diagnosed using exactly the same tests that you would use to diagnose an MI, and which can also provide useful info about the likelihood of a PE.

Original poster

whateveryouwantmetosay · 08/06/2022 02:18

Thank you for the comments. I know that no one can give me the exact answers here, only his doctors can. I'm just trying, for myself, to prepare for the worst. It makes no sense to me either that he was ventilated so quickly, and they've been quite vague too (which is pissing me off actually).

Today he had CT scans of the chest and abdomen-all clear. They turned down the sedation a bit and he moved and maybe tried to open an eye (but not sure). They have said they will wean him more tomorrow provided he stays stable overnight.

Does anyone know if it's reasonable to presume (because no one asked this and the drs were "too busy" to bother talking to any of us today), that if he's trying to move he's also trying to breathe? Or is that not necessarily true?

OP posts:

Original poster

whateveryouwantmetosay · 08/06/2022 02:19

Greybeardy · 07/06/2022 13:13

OP, no one on here can really give you the answers you're looking for - the team looking after your FIL will have mountains of information that will be informing their management. Broadly speaking though, moving intubated ICU patients, even relatively stable ones, is a high risk manoeuvre and the benefits of getting the test results have to outweigh the risk of the transfer. In ICU patients the clinical picture can also change quite quickly (and transiently) requiring more or less support & equipment and that may also affect the decision making. Your first post mentions that they think he has pericarditis, which is not usually diagnosed primarily by CT, so if they're reasonably certain that that's the primary problem then the scan may not be the most urgent investigation and there may be a bit more flexibility in the timing.

@Samarie123 there are options for supporting ventilation non-invasively before intubating patients, but sometimes it's so barn door obvious that someone's going to end up on a ventilator that working through the other options is not appropriate or safe.

@Goodskin46 the description of the deterioration is so vague it fits with almost any cause of collapse, including PE/MI. The OP's first post said the team think the problem is pericarditis though, which is usually diagnosed using exactly the same tests that you would use to diagnose an MI, and which can also provide useful info about the likelihood of a PE.

@Greybeardy they did say that he had a "pre-heart attack" and that was the reason for ventilating him to prevent an actual heart attack and allow his body to rest. I don't know if that's accurate, but that is the message that was given by SIL.

OP posts:

Original poster

whateveryouwantmetosay · 08/06/2022 19:54

Sorry, me again.

Dr today said something about "intercostal" something of the lungs. Any idea what that is? I'm sorry to keep asking. I'm not there so I can't be asking these questions myself and I don't think DH or SIL are in a frame of mind to know exactly what to ask. Any help is appreciated.

OP posts:

Hairyfairy01 · 08/06/2022 20:17

Intercostal are muscles by the ribs. I'm no medic, but could this be what they are referring to?

Original poster

whateveryouwantmetosay · 08/06/2022 20:20

I'm wondering if what they heard was "intercostal" but what was meant was "interstitial"....I've let them know to ask that question.

OP posts:

Hairyfairy01 · 09/06/2022 21:55

I hope you got some answers OP.