subee, MSN, CRNA 4,773 Posts Specializes in CRNA, Finally retired. Has 51 years experience. Jul 8, 2021 On 7/5/2021 at 10:44 PM, Aliareza said: So to make a long story short, she didn't get vaccinated and caught COVID in early June. She was hospitalized on the 11th and slid downhill until she had to be intubated. She got a night's warning so she was able to tell us her wishes regarding the decisions we'd likely be facing in the days ahead and to tell everyone goodbye. I do have critical care and ventilator experience as an RN but left bedside before COVID so I haven't personally done acute or critical care for COVID. I worked in outpatient testing and an outpatient COVID treatment clinic, so I'm not entirely unaware of the possibilities of long term effects. Today is day 8 for my mom on her ventilator. She's down to PEEP 13 and fio2 of 55% but that number hasn't moved in a few days. Her chest x-ray showed some clearing of her right lung a few days ago but no progress since then. We've been told she'd have to be maintaining with 40-45% fio2 and PEEP 8 to try to come off the vent and she isn't there yet. We know that by day 14, they'll want to go the trach and peg tube route if she isn't ready to be extubated. The longer we go, the more things slip (fevers, skin breakdown, delirium) and I frankly don't see her making it to her goal. That leaves us with a very difficult question: do we pull support? She told us that she didn't want to live if she couldn't have a high quality life in which she lived at home independently and could essentially return to work and taking trips and go back to living a normal life. Since she's made Some progress, it's hard for me to know whether she just needs more time or if we're dooming her to life in LTAC hell until the next cold comes and finishes the job. I am in no way seeking medical advice and I don't need anyone to tell me what to do; instead, I was hoping that perhaps nurses who have worked with ventilated COVID patients might be able to tell me about their personal and professional experiences so that I can better gauge the reality of what I'm looking at. I have a decision making conference with her teams and my family on Friday to try and help us make an informed choice for her, and it's one we will have to make as her children since she's single/divorced. I know it's likely not a positive prognosis. Life after an extended ICU stay and significant time on the vent even without COVID is often never the same. Any input would be much appreciated. You will have to decide what YOU want to do. Your mother is beyond any other help. Can you live comfortably with your decision? IMHO, her chance for survival is in the single digits and it won't pretty or comfortable for her afterwards if she did live long enough to graduate to long-term vent in a nursing home. If you do go to the comfort measures only regimen, you haven't done anything except to make her more comfortable and should have no regrets. I had to fire my mother's doctor because he wasn't comfortable with just referring to hospice and calling it quits. At least in such a terrible situation I was able to help her die comfortably.