Hospitals & Services
Ideally 2 x MO ICU Consultant
NIB 3-5min cycle
ETT cuff pressure
Ensure adequate assistance, monitoring and equipment as for intubation.
Extubation should generally not be performed when the responsibility to re-intubate might fall on a less experienced staff member. Patients may be extubated if this action is part of an established care plan or algorithm (eg; cardiothoracic).
No patient should be extubated without medical staff being present and available to assist.
The patient should be awake enough to maintain their own airway.
Any threat to airway patency as a result of surgery or injury requires consultation with the co-managing team (ENT or Plastic surgery) prior to extubation.
Patient should demonstrate adequate pulmonary reserve. There are a number of ways of assessing pulmonary reserve although none is perfect:
Resp rate <30
FVC > 15 ml/kg
PaO2 / FiO2 ratio > 200