Extubation Criteria

A lot of attention is placed on intubations, however extubation of a patient is just as important and requires diligence and preparation in order to avoid complications. Routine extubation at the end of a surgical procedure is generally very safe, but it is reasonable to have back up equipment readily available or know where it is to grab in the case of needing to reintubate. If you go about this process in an organized and systematic manner, you can create a safe scenario for the patient to be transferred to the PACU for remainder of their recovery. Most providers pick up on this process quickly in training and do many of the right moves without thinking about it, but let’s review the steps that go into extubating a patient. First you must decide if you want to wake the patient up fully (majority of scenarios) or extubate under a deep level of anesthesia. The big benefit of extubating under a deep plane of anesthesia is avoiding coughing which may increase blood pressure, intracranial and intrabdominal pressures, or risk disrupting surgical sutures around the head/neck/chest regions. Saving time is not a good enough reason on it’s own to justify a deep extubation. A patient is still at risk for airway obstruction either from soft tissue collapse or laryngospasm after extubation and needs to be monitored closely. In order to safely perform a deep extubation, ensure that your patient: - Has no remaining neuromuscular blockade - Had a good airway with an easy intubation - Has no increased risk for aspiration - Is normothermic with normal vital signs - Is breathing with little to no positive pressure support and achieving adequate tidal volumes To read more, check out keywordsxkenny.com and look for the latest post on “Extubation Criteria”! (*Link in bio*) #anesthesia #anesthesiology #residency #surgery #medicine #operatingroom #crna #srna #training #medicaltraining #anesthesiaassistant #medstudent #medschool #medicalschool #physician #nurse #extubation #criticalcareunit #respiratorytherapist #meded #foamed