Ariel Sharon to have tracheotomy

[emad]

Israeli Prime Minister Ariel Sharon is to undergo a tracheotomy within the next few hours to help to wean him off a respirator, hospital officials say.

In the procedure, doctors will cut a small hole in his neck to insert a tube into his windpipe.

Doctors are trying to wake Mr Sharon from a medically induced coma, 10 days after he suffered a massive stroke.

Tests have shown activity on both sides of Mr Sharon's brain. His condition is said to be serious but stable.

The prime minister is also expected to undergo another brain scan on Sunday.

http://news.bbc.co.uk/1/hi/world/middle_east/4614940.stm


THIS IS what JP2 had, just days before he finally died.

[still_one]

1. He must have pneumonia

[rainbow4321]

9. Not necessarily...

It's a step taken on people who, for whatever reason, won't be able to breath normal for a very long time...brain damage or diseases (paralysis, other neuro diseases that impair one's breathing ability). Could he get pneumonia? Definitely. Even having a trach can't prevent that from from happening.

[qanda]

2. I wonder if he had a living will

I would not want to exist in that condition.

[w8liftinglady]

4. Particualrly someone who prided himself on his strength and fortitude..

[megatherium]

10. I read somewhere that he did not have a do-not-resuscitate order. nt

[MuseRider]

3. This is routine

when someone is on the ventilator for a long time. Many times we used to do it after 3 days if we knew the patient was going to be on it for a while.

[w8liftinglady]

5. true-which means this could last forever...

I work with vent-dependent patients.This has a historically poor outcome(failure to wean post CVA)

[MuseRider]

6. True,

I was thinking first more along the lines that he is a neuro patient that they are trying to awaken and those ET tubes are extremly uncomfortable and any agitation that he would have from it would cause his pressures to go up hence making him more likely to stroke again.

As you know, it is much easier to tolerate a trach. They are also easier to work with although a little more labor intensive but all in all I always felt like we were able to take better care of the respiratory system when they were trached.

I suppose there is no way of knowing what his outcome looks like really, I have seen patients recover from this but it is looking pretty bad for him (that is my official Dr. Frist diagnosis meaning I have no way in hell of knowing anything about this from my computer but I am happy to tell you what I think, lol).

[DoYouEverWonder]

11. But last week they said he was breathing on his own

and they were just keeping him on the respirator has a precaution. Now he still hasn't 'awakened' and they going for a trach, does not bode will for the PM's real condition. He sounds like a goner but thanks to medical technology they can now keep him 'alive' forever if they so choose.

[MuseRider]

12. That is usually because

when you have a brain that has experienced trauma you need to do everything you can to avoid agitation etc. I am not arguing, I am certain that he is seriously ill but if we do not know the results of his brain scans we can't really know if they are just keeping alive forever.

Of course I must say that I have been out of critical care nursing for a long time but neuro patients were my favorite and unless things have changed a lot these treatments would still hold true.

I do have to add that I had a patient once who had a severe brain injury and was not expected to recover. When I left for vacation he was being prepped for retrieval protocol so when the family decided it was time to let him go we could use his organs. When I came back he had been transfered out, he woke up the day they were prepping him for the retrieval. :shrug: This treatment that Sharon is getting was not, back in my day, unusual. Now I suppose for us "little people" these days it would not be as likely.

[AngryAmish]

21. Tracheal stenosis

One of the main causes is long term (many day) intubations, as well as using too big of a tube. If one has a tube in for too long it will kill the inside of your trachea. Then when one is awoken and the tube comes out the tracheal will close and one dies.

But MR, you know that. This is one area of medicine I know something about. I was surprised that they didn't trach him sooner. (I'm also not a doctor and I really have no real idea what is going on).

[Tesha]

22. It would have been bad PR.

> I was surprised that they didn't trach him sooner.

It woul dhave been bad PR. We all knew he was
gone from the first news story, but they need
to manage the political PR fall-out.

He should have had an advance directive. :-(

Tesha

[Tom Joad]

7. Sad. Never will be able to face charges for war crimes.

[foreigncorrespondent]

19. The way I Have been lookng at it has been...

...that just maybe he is facing his punishment now. Meaning a once very strong guy could very well come out of this as a vegetable. That is the worst kind of punishment for anyone.

[rainbow4321]

8. They will do the same thing as docs did to the surviving miner..

Trach and feeding tube. It gets to a point where neither of them will be cared for in the ICU..instead they will probably be transfered to more of a lower acuity, long term care area. Except I imagine Sharon's hospital won't word it that way cuz it will make it sound like they have given up and that may bring on more political issues...

[daleo]

13. I think this is a key point

"Israel's Attorney General Meni Mazuz released a statement on Sunday saying that under Israeli law Mr Sharon cannot be declared permanently incapacitated for another three months.

He directed Mr Sharon's replacement, Ehud Olmert, to stay on as acting prime minister until Israel goes to the polls on 28 March."

If he dies, I think that ruling wouldn't apply, and there would have to be an immediate election. I could be wrong, and the various BBC articles aren't clear on the point. Anyway, it is more than just a medical or religious issue, although it's those too.

[FlemingsGhost]

14. Any chance of a lobotomy, while they're at it? (n/t)

Flem.

[SoCalDem]

15. Sharon "died" when he had his stroke.. They are just keeping his

corpse "alive".. There's a lot of behind-the-scenes scrambling going on, and once things shake out the way they want, he will be allowed to "officially" die.

[FlemingsGhost]

17. "Weekend at Ari's"? ... Oy! (n/t)

Flem.

[ckramer]

18. Nothing is truer than what you say here...I believe you...

It's "body politics", won't you say?

[Algorem]

16. he won't die til they complete his walletectomy

[Scurrilous]

20. Senior physician: PM could be declared as being in vegetative state

<snip>

"Prime Minister Ariel Sharon, whose doctors began trying last week to bring him out of a state of induced coma, still shows no significant signs of reviving.

A senior physician who is an expert in intensive care and comas told Haaretz on Sunday that, according to reports by doctors treating Sharon, if the prime minister's condition persists into next week - he is still unconscious and connected to a respirator - he may be defined as being in a vegetative state."

<snip>

"According to the physician: "Few people of Sharon's age have regained consciousness after such a massive stroke as the one the prime minister had, especially after three emergency operations."

The doctor added that when he has to speak to the family of an individual in such a situation, he tells them: "He will not fully regain consciousness. He may be able to breath alone and will not need equipment, but he will remain severely disabled."

more