Extubation

Airway · ICU/Anesthesia · 10–20 min

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

1. Confirm criteria

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.

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WardRound

Clinical Decisions in Seconds