Kevin Lightner
- Thread starter 73 Red I
- Start date
IF he pulled his trach tube out on his own, the hospital and docs didn't have him medicated heavily enough. I would probably rather just take my chances with the high flow oxygen than be put on a ventilator. He's 55. Hope he can beat it.
Make sure to indicate that in your advance directive and communicate it to your decision maker so you don’t get put on one
Unfortunately he played at a time when PED use was rampant and he could have residual cardiac effects if he used them. Having been put on a ventilator already, I would guess his prognosis is not great.
I like the modest ask for only a $500K policy from a stranger. We're not being unreasonable here.Can you buy a $500k life policy and name me as your beneficiary, dingle?
That was my reaction as well, if he was actually intubated for a vent my understanding is they don't just let you lie awake and decide if you enjoy that or not. Probably they were giving him some oxygen or he had some kind of nasal tube if he pulled something out.
On a related note,
My wife's cousin has had the virus for the past 2 weeks. She got it having random sex at a bar. She has sinus congestion and that is about it.
What is odd about this is that she is one of the most unhealthiest people I know.
- Morbid Obesity. (350+)
- Has Colitis
- Chain smoker for last 30 years
- 50 years old
- Doesn't sleep
- Drinks copious amounts of alcohol and energy drinks
- Stressed to the gills
My wife's cousin has had the virus for the past 2 weeks. She got it having random sex at a bar. She has sinus congestion and that is about it.
What is odd about this is that she is one of the most unhealthiest people I know.
- Morbid Obesity. (350+)
- Has Colitis
- Chain smoker for last 30 years
- 50 years old
- Doesn't sleep
- Drinks copious amounts of alcohol and energy drinks
- Stressed to the gills
there has been a huge evidence based shift in approach to mechanical ventilation over the past decade where it is the goal to have patients as awake and interactive as possible while on a ventilator
good evidence that higher levels of sedation for longer periods of time lead to worse outcomes - both survival and poor neurocognitive outcomes - Alzheimer's like
we routinely have patients sitting in a chair, sitting at the edge of the bed, standing, marching and even walking on a ventilator
being awake also allows patients to communicate about pain and discomfort, interact with loved ones etc - have had patients writing, on ipads, etc
delicate balance and much more labor intensive than just keeping everyone comatose
usually start heavily sedated and then rapidly deescalate sedatives
http://www.mobilization-network.org/Network/Welcome.html
https://www.nytimes.com/2009/01/12/health/12icu.html
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I swear sometimes that when I woke up in the morning they switched women on me from the night before.
I asked my wife how having sex with her was physically possible.
One of the mysteries of the universe
RollingLaugh
Can't speak for anyone else, but the "How drunk do you have to be" curve would start to intersect with "I'm to drunk to make it happen" curve....and would figure the hangover that is sure to follow as an investment.
You’d be surprised how many go in without any intoxication at all. Then again, maybe no surprise as all.
there has been a huge evidence based shift in approach to mechanical ventilation over the past decade where it is the goal to have patients as awake and interactive as possible while on a ventilator
good evidence that higher levels of sedation for longer periods of time lead to worse outcomes - both survival and poor neurocognitive outcomes - Alzheimer's like
we routinely have patients sitting in a chair, sitting at the edge of the bed, standing, marching and even walking on a ventilators
being awake also allows patients to communicate about pain and discomfort, interact with loved ones etc - have had patients writing, on ipads, etc
delicate balance and much more labor intensive than just keeping everyone comatose
usually start heavily sedated and then rapidly deescalate sedatives
http://www.mobilization-network.org/Network/Welcome.html
https://www.nytimes.com/2009/01/12/health/12icu.html
https://www.google.com/imgres?imgur...hUKEwiA7-Ld_YTrAhVRXawKHS5lDpwQMygAegUIARCqAQhttps://www.google.com/imgres?imgurl=https://thumbs.gfycat.com/AgreeableSelfishGopher-max-1mb.gif&imgrefurl=https://gfycat.com/gifs/search/shallow+hal&tbnid=-V5bo2ew3NUYmM&vet=12ahUKEwiA7-Ld_YTrAhVRXawKHS5lDpwQMygAegUIARCqAQ..i&docid=uriAXHrGk2jSSM&w=240&h=133&q=shallow hal gif&ved=2ahUKEwiA7-Ld_YTrAhVRXawKHS5lDpwQMygAegUIARCqAQ
Amazingly some guys like big girls. Some are just plain desperate and probably aren't any more attractive than her.
And then you get the non-compliant patient who pulls their trach out. Personally I can't imagine having an endotracheal tube in without being heavily sedated.there has been a huge evidence based shift in approach to mechanical ventilation over the past decade where it is the goal to have patients as awake and interactive as possible while on a ventilator
good evidence that higher levels of sedation for longer periods of time lead to worse outcomes - both survival and poor neurocognitive outcomes - Alzheimer's like
we routinely have patients sitting in a chair, sitting at the edge of the bed, standing, marching and even walking on a ventilator
being awake also allows patients to communicate about pain and discomfort, interact with loved ones etc - have had patients writing, on ipads, etc
delicate balance and much more labor intensive than just keeping everyone comatose
usually start heavily sedated and then rapidly deescalate sedatives
http://www.mobilization-network.org/Network/Welcome.html
https://www.nytimes.com/2009/01/12/health/12icu.html
it is not a patient issue or question of compliance if the endotracheal tube gets dislodged - occasionally happens but shouldn’t- every case gets debriefed and reviewed in M+M
We don’t blame the patient
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IF the patient pulls the tube out on purpose then in fact it IS a patient issue. The LJS story made it sound as if he pulled it out on purpose.
do you think a patient who most certainly has recently been on or is on some degree of sedative/opioid medications (anesthesia) and is critically ill is responsible for their actions? Do you think if he would have died the hospital could have just shrugged and said oh well he pulled it out on purpose - not our problem. Better yet why did they put the tube back in if he wanted it out.
It is up to the medical team to keep the patient safe. We don’t blame the patient
What's your point? Clearly in hindsight he needed more sedative. My original post which I edited because I don't like to throw medical professionals under the bus said "somebody screwed up if he pulled his trach tube out on purpose". It happens.
Maybe he needed a different sedative or none at all or just pain focused meds
There are meds that allow you to be calm and awake
maybe the rate of medication withdraw was too quick.
the most at risk time for these events is coming out of deep sedation - have to be ready to intervene
so no ... I disagree with the statement that “clearly he needed more sedative” That is often not the case and if it was then then staff was not in a position to intervene to keep him safe
Agree it happens .. but the answer is rarely more sedation
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Ok. The term "sedative" encompasses a lot of drugs. Sedative effects can be achieved by a wide range of drugs some of which can keep you calm and still be awake. IF the medication was withdrawn too quickly then at that point in time, he needed more. Right? Somebody f'd up. I'll leave it there.
Yes, it is amazing. Our local Walmart daily shows women bigger than than a TRex and always with little skinny guys. Lol! It's really something.....
This thread has restored my faith in humanity. There is hope that anybody, and I mean anybody, can get laid.
On a side note I'm glad I was eating breakfast by myself. It would have been awkward to explain to the family what the laughter was about.
On a side note I'm glad I was eating breakfast by myself. It would have been awkward to explain to the family what the laughter was about.