Removal of ETT after weaning criteria met.
Indications
- • Underlying condition improved
- • SBT passed
- • Adequate cough & mentation
Contraindications
- ⚠ High airway edema risk (leak test negative)
- ⚠ Impending resurgery
Equipment
- • Suction
- • BVM ready
- • Post-extubation O2 device
- • Reintubation kit at bedside
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/6)
Tap to complete
SBT passed, GCS ≥ 8, cough present, adequate oxygenation on minimal support.
2. Suction subglottic & oropharynx
3. Deflate cuff
4. Ask patient to cough
5. Apply O2
6. Post-extubation monitoring
Immediate complications
- ⚠ Laryngospasm
- ⚠ Aspiration
- ⚠ Airway edema/stridor
- ⚠ Failure needing reintubation
Delayed complications
- • Post-extubation dysphagia
Recognition
- • Stridor, desat, retractions
Initial management
- • Nebulized adrenaline; steroids; reintubate
Prevention
- • Cuff leak test in high-risk cases
- • Steroids pre-extubation if edema risk
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
