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waltwhitman83 t1_j2tsdhk wrote

> He will remain induced until he can breathe on his own

I don't get this. He's in a coma, therefore he needs a ventilator.

They're going to try to bring him out of the coma, turn the ventilator off, he tries to breathe with it still in his throat, if it fails they turn it back on and put him back out?

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RasputinsAssassins t1_j2tu2bf wrote

They can dial back how much assistance the ventilator is providing, I believe. That's what they did with me (or at least how it was explained to me).

When they brought me out to check brain function, the tube was still down my throat. It hurts, it triggers the gag reflex...it is not pleasant, and it almost feels like you are choking. That's one reason (among the others) people are typically sedated when on a ventilator. It can easily cause you to freak out and start thrashing, which runs counter to the whole idea of getting rest and healing.

So, they may take it from 100% assistance to 90%, to 80%, etc. It will reach a point where they think the body can do it on its own, and that's when they will consider bring him out.

Think of it like those machines (like the assisted pull up machine) in the gym that have a weight assist on them. You can dial back how much of the work is being done by the machine assist. It allows you to continue with the exercise so that you can do it properly and reap the benefits, and as you get stronger, you can turn down how much assist the machine is giving, until you are at a point you can do it all on your own.

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tkp14 t1_j2u0thq wrote

A couple of years ago I contracted a norovirus which was extremely unpleasant and causes a person to violently expel from both ends. (Such a charming experience.) I ended up being taken to the ER because the expelling would just not stop. They put in an IV to re-hydrate me and to give me antiemetic drugs. They also put in a nasogastric tube - a very thin, soft tube that goes in through the nose, down the throat, and into the stomach. They were concerned that the uncontrollable vomiting might start up again and suffocate me. The tube had to remain in for 24 hours, though I’ve read that often patients have to endure it for a lot longer. And “endure” is the right word. That skinny little tube hurt like a bitch. It put the whole “get Covid and wind up on a ventilator” in perspective. I cannot begin to imagine how awful a ventilator feels.

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waltwhitman83 t1_j2tufi6 wrote

> That's what they did with me (or at least how it was explained to me).

when you were conscious or in a coma?

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RasputinsAssassins t1_j2tzmq3 wrote

>when you were conscious or in a coma?

They didn't explain much to me while I was in the coma. If they did, I have no recollection.

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RasputinsAssassins t1_j2u01gk wrote

They aren't going to wake him up from the coma until they think he can breathe on his own. They determine that by dialing back how much help the ventilator is providing.

They may bring him out long enough to ask a question and stick him with a pin to see if he still has cognitive function.

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waltwhitman83 t1_j2tuhyl wrote

> That's one reason (among the others) people are typically sedated when on a ventilator.

if you're sedated, can't you "not breathe on your own" without the ventilator? or is it like being asleep? or are there different levels?

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RasputinsAssassins t1_j2tzfn1 wrote

I'm not sure I understand what you are trying to find out.

A ventilator assists your breathing. It can do 100% of it for you, or it can do (I don't know the number) 10% of the breathing, and your body does the remaining 90%.

Again, I was a coma patient; I am not a medical; professional. A person who is sedated for something like a minor procedure (think a colonoscopy or an eye surgery) is awake and may be aware, or they may be simply put to sleep with drugs. Those folks can still breathe on their own and don't need a ventilator, because they are only partially sedated.

As you get more drugs for a deeper level of sedation, you breathing slows down.

A person who is put into a deeper level of sleep, like for a major surgery, may or may not get intubated with a ventilator. They may still be able to breathe on their own, but the drugs cause respiration to slow, and that can be dangerous, depending on what's happening. So they may go on a ventilator, if it is felt is needed.

A person who is medically induced is, I believe, usually intubated with a ventilator. They let the ventilator do the heavy lifting so the body can repair itself. Again, they heavy drugs slow respiration.

The ventilator does tit's work whether or not you are sedated. They sedate you because it's a scary friggin' experience to have a tube shoved down your throat, completely blocking it. It felt like a hard or corrugated plastic, and it was not pleasant. I began to freak a little, but they calmed me down enough to get their test done and then put me back under.

Those commercials that have been running in some areas of the US about not having a glass of wine with your Oxy? It's warning you because that combo is effectively sedating you to a level where your respiration can slow to a stop.

I do not remember anything about my coma, except a very weird thing when they put me back under. it's not the same as being asleep, IMO. I had no concept of the passage of time. I woke up five days later and thought it had been a couple of hours. I had a follow up surgery months later where I was just under general anesthesia for the surgery (knocked out) and it felt like I was out for 15 minutes. It had been 7 hours. I felt like Scott Lang in the Quantum World.

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tmahfan117 t1_j2u2baz wrote

It depends on how deeply you’re sedated.

But like the vast majority of the time people can breathe on their own while sedated. Like anytime someone gets knocked out for a planned/routine surgery they’re sedated.

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strykerdoc t1_j2u3idp wrote

Not a doctor. Former paramedic and current nursing student.

You are typically given two different drugs. One is for sedation, can be propofol (what killed Michael Jackson) or versed, or a couple others depending on doctor preference and local protocols. The other drug is a paralytic, so that you're not fighting the tube or mechanical breathing.

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Greener441 t1_j2uie2i wrote

>They’re going to try to bring him out of the coma, turn the ventilator off, he tries to breathe with it still in his throat, if it fails they turn it back on and put him back out?

without getting technical, yes, pretty much.

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