	AllExperts > ICU/Critical Care
	Search

About Wesley
Expertise
I can translate the jargon and answer the complex emotional and medical questions related to an ICU stay. I am a constant student of the changing face of Medicine, and hopefully I can help you come to a better understanding about what you can expect during your stressful time. I find that once the language is explained a little clearer, the puzzle comes more into focus. Usually, just to know that you are not alone may help. I am familar with all facets of critical care except transplant and neonatal care. Questions about Sepsis, ventilation, gall bladders, hemodialysis, complicated cancer surgery and alcohol withdrawal, suicide/overdose attempts are welcome. Students are welcome

Experience
12 years as an ICU nurse and 2 yrs on Neurosurgery. Mentor, teacher, been there in your shoes myself.

Education/Credentials
BSN from Clemson, 15yrs grunt medic in the ARMY.

You are here: Experts > Health/Fitness > Medical Specialists > ICU/Critical Care > Mother on a vent from emphysema/pneumonia and heart attacks.

pneumonia and heart attacks.

Expert: Wesley - 11/4/2009

Question
QUESTION: Last Thursday on the 22nd my mom was rushed to the hospital with chest pains. We went there and they said she had a mild heart attack but all was ok. She was roomed from emergency room to her co-shared room with another patient. my mom was up and awake and had full mental stability. The doctors then told use that her heart attack was bought on by emphysema, her weight and a bout of pneumonia. So we stayed till we were allowed to and we were kicked out well after visiting hours.

The next day we are getting ready to go when we find out she has had yet another attack. Over night she refused 2 breathing treatments and took one in the morning and had a heart attack. We run up and now she is in ICU sedated.

The attending doctors told us that her lungs arent able to give her O2 so now she is on a ventilator and sedated cause the tubes are down her throat. her heart rate is high at 110+ and her o2 sats are at low 90's at 60% vent. They tell us its gonna be day to day due to the pneumonia.

After 3 days they finally give her lasix and a beta blocker. her heart rate comes down to 70's/80's and her 02 had to be increased to 70% to stay in the low to mid 90's sat even while still being sedated. They have her on a rolling bed to make sure of no bed sores. and every morning they wake her for 20 to 30 minutes to explain to her whats up and to see her stats and vitals. which struggle and then they sedate her again.

Now starting yesterday, her heart rate has gone back up to 100 to 113. her vent is still in same area. a lot of mucus has been being suctioned out from the lungs. and now she has a low grade fever of 99.

What is going on here? how long can my mom withstand this? is this normal for this situation? why arent they doing anything for the rapid heart rate? can they do anything? my mom lost 60 pounds over the last year.. she was doing well. is 9 days too short to expect anything to be ok and fixed? or is this a long process? what can i expect the doctors to do to try and make her better?

Thanks

ANSWER: Actually, Nick this all sounds by the book. She lost a lot of weight, I bet her lipids are really high, thus the heart attack.

You give a point by point description of what should happen in this scenario. Sedation, rotation and awaken. Perfect.

We don't normally 'treat' high heart rates. It is usually not necessary because it is a compensation and slowing it down actually is harmful if the body wants it to be higher. The fever can make it high, being more awake at certain times and other subtle things affect it, so treating it can be random and hard.

9 days is just a start I'm afraid. Expect them or rather require them to talk to you daily, this goes a long way. I hope she gets back to you soon.

---------- FOLLOW-UP ----------

QUESTION: Well now its nov 4th, and i see you are saying this is gonna be a long process. Last night they were re-adjusting her breathing tubes when her heart rate went up to 125. now its back down to 101. Im worried about her heart after the 2 attacks being so fast.

Her pneumonia was clearing up. her vent went from 60 to 70% to keep her in the low to mid 90's and now are back down to 60% for low to mid 90s sats. But a few days ago when her fever started, a new pneumonia has introduced in her other lung, the left one.

so now they have her on a spectrum of anti biotics while waiting on blood cultures from 2 days ago that show nothing coming back. They are looking at a possible tracheotomy for my mom. but im worried when they wake her up that she will reject it in fear of it being the old time quit smoking ads that were hammered into their heads and that it will be permanent.

So were her heart attacks from the emphysema, pneumonia and her weight issue causing her lungs not being able to pump O2 into her blood or is it from the year long weight loss? What things do i need to ask to help prevent? any possible bad outcomes from this? What normal outcomes can we expect?

any and all advice will be wanted and welcomed.

Answer
I hope you have had time to read some of the many posts about the trach I have answered. They are not permanent, and leave little to no scar.

I think the best thing to remember about this phase is that small steps are important. There will be days when things don't work as well. As long as she progresses towards weaning, the MD's and nurses have done a great job so far, stay open and ask questions. Communication is the best thing to prevent problems.

Add to this Answer Ask a Question