ICU nurses please.... any help?

  1. I have a question about responses from an ICU patient. Let me start out by saying that I am a pre-nursing student and this is a personal question. I am not asking for medical advice just some possibilities.

    My brother is a pt in an ICU unit, he was taken by ambulance to the hospital where he was reported as non responsive, after CPR administration he was "somewhat stable??" at best. He is breathing with assistance and they have done dialysis (his kidneys function at less than good levels--this is not new) but they are doing that to reduce the amount of fluid etc. He does not seem to respond a great deal, although they did say today he grimaced at pain and did move one of his legs (not at a request he just did) . They are not administering pain meds . at one point today he did open his eyes and seemed to get stiff, his wife was attempting to wash his hair at that time.. we are not sure he was reacting to that or ??
    He did have a CT, shows no hemorrage , essentially normal, no bleed etc. They were doing an EEG today. My question is this??

    First they told us that he cannot hear us??

    I am curious about the reaction, the stiffening of the legs ,opening eyes.. I dont want to be too optimistic or pessimistic but I am thinking it coul djust be the brain firing and not actually a conscious effort on his part to react?? any input would be appreciated.
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  2. 13 Comments

  3. by   cmo421
    This is a difficult time for you and your family, I hope all goes well. It is very difficult to determine what your brothers level of functioning is. Much depends on the length and quality of CPR. Sometimes there is brain swelling after lenthly resusitation, and of course there is always the chance of an anoxic injury. Sorry to say that it is a waiting game at best. Good Luck! Hope is always a good thing!
  4. by   oMerMero
    My usual response to "can he hear me?" It is often hard to know what a patient hears and understands and what he does not. So, go with the assumption that he can hear you. Talk to him as though he is listening, tell him what you want to tell him, let him know you are there with him. It can feel strange talking to him and not having him respond, but still talk to him. There are patients who wake up and remember bits and pieces of people talking. Try to keep conversations about his prognosis out of the room though...just in case he can hear. Every patient is different, and you may never know what he hears, but assume he hears it all.

    I am sorry to hear about the situtation you are going throuhg.
  5. by   Tweety
    Unless they are sure that area of the brain is injured, I would presume he could hear and continue to do cognitive stimulation by talking to him and talking often. That's just me.

    I'm extremely sorry that your family is going through this nightmare.
  6. by   Need2Wings
    Thank you all for your responses, your well wishes mean a lot to me and my family. We are hopeful but trying to be realistic at the same time. Initially it was very difficult to talk to him, its getting a little bit easier. We just arrived here this morning (Tennessee) from home which is Michigan, but each visit it does ((just came back from #3))get a bit easier to actually talk to him. I suppose its the initial shock of seeing him like that. His color has improved, they have turned down the O2 attempting to get him breathing more on his own, they say he's doing ok.

    thanks a billion.. !!!!
    Dana
  7. by   leslie :-D
    you need to understand that unless doctors are totally confident in their assessments, any prognosis is certain to be vague, if not dismal, to err on the side of caution.
    esp when it comes to any measure of anoxia, it remains the grayest area in regards to level of function.

    even when docs have reported the most primal of brain stem activity, incredible stories of recovery have been shared.
    i always talk to my pts, regardless of their loc.
    always, always, always.
    i tell them the date, time, weather, stories about their families and keep them close to me and my reality.

    i am so very sorry this has happened.
    by all means, talk to him, if only to communicate your love.

    wishing you peace and hope.

    leslie
  8. by   Mayflye
    What were his injuries? Was he in a car accident? And yes, I believe pts can hear and recognize voices. If he seems to be in pain, ask for pain medicine. Any sedation they are giving him does not control pain.
  9. by   grbrico
    always always always talk to them... even if they say they can't.. its not only therapeutic for the patient.. but also for the family members... Im so sorry you are going through this.. my prayers are with you.
    Rae
  10. by   fluppypacky
    First,sorry to hear about your story. IFor what I know,patient who were unconcsious can really hear. For what I know the last senses to loose is hearing. Just continue talking or telling something to him. I know it's hard to do that because of the mix emotion,but believe me,he can hear you.
    Quote from Need2Wings
    I have a question about responses from an ICU patient. Let me start out by saying that I am a pre-nursing student and this is a personal question. I am not asking for medical advice just some possibilities.

    My brother is a pt in an ICU unit, he was taken by ambulance to the hospital where he was reported as non responsive, after CPR administration he was "somewhat stable??" at best. He is breathing with assistance and they have done dialysis (his kidneys function at less than good levels--this is not new) but they are doing that to reduce the amount of fluid etc. He does not seem to respond a great deal, although they did say today he grimaced at pain and did move one of his legs (not at a request he just did) . They are not administering pain meds . at one point today he did open his eyes and seemed to get stiff, his wife was attempting to wash his hair at that time.. we are not sure he was reacting to that or ??
    He did have a CT, shows no hemorrage , essentially normal, no bleed etc. They were doing an EEG today. My question is this??

    First they told us that he cannot hear us??

    I am curious about the reaction, the stiffening of the legs ,opening eyes.. I dont want to be too optimistic or pessimistic but I am thinking it coul djust be the brain firing and not actually a conscious effort on his part to react?? any input would be appreciated.
  11. by   deeDawntee
    I am soooooooooooo sorry that you and your family are going through this. It is such an incredibly difficult time. The thing is, as other have said, is that you just never know. And I definitely would keep talking to him and touching him.

    Is he still vented? How long has he been on the vent? Are they talking about a trach? Are they feeding him? Is his blood pressure stable? Is his renal status improving?

    My prayers and thoughts go out to you. Did your brother ever talk to any of you about being on a vent or having a feeding tube? Is that what his wishes are? Has your family been able to talk about any of that? I know it is a very difficult subject, but it may be something many of you are thinking about and to discuss it may be helpful.
  12. by   Need2Wings
    Morning to all, thanks for the additional support and information. We continue to talk to and touch him as much as we can. He is not sedated at all, he's in a vegetative state. They tried the feeding tube but it appears he's not tolerating it, so last night the nurse did stop it.

    He was not in an accident, its a long story really but he had several health issues and one of them was the kidney problem, apparently he was having difficulty breathing, an ambulance was called and when he got the the ER he was unresponsive. They did CPR and this is where he has been since.

    I think the dr's have been pretty up front, the ICU dr was pretty honest last night. The issue of DNR did come up last night, although since he is married his wife obviously makes the decision, she wishes to wait 4-5 days to make a decision. I thought the dr and nurse last night did a good job of explaining. We have had those discussions and I am sure he discussed it with his wife also. She hopes he will improve today since they did the dialysis yesterday. Its a waiting game at this point.

    I do want to thank you all for your kindness and support!!

    Dana
  13. by   BBFRN
    Just wanted to send out hugs and prayers to you and your family. So sorry you are going through this right now. Take care.
  14. by   Nursebarebari
    I am very sorry to hear about your brother in this situation.
    But to my understanding, hearing is the last sense to go, so please always, always talk to your brother. If he likes singing or he has a special song, sings to him.
    I am not saying the doctors are wrong, but they are not always right.
    Good luck and may the outcome be good.

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