1) patient spontaneously ventilating
2) reversed adequately: sustained tetany w/o fade > 5 sec is one way to do it.
3) vital signs stable
4) not in stage 2
Book stuff:
RSBI < 100. Respiration rate/tidal volume in Liters.
nif <-20mmhg (you can take off bag and cover hole with hand and have patient suck in while watching pressure gauge
leak test for airway surgeries/long prone case (dunno how useful it is in reality)
Patient either deep or awake
Patient either breathing or easy to ventilate manually
Oral airway in place
Pharynx suctioned
Cuff deflated
Lungs manually inflated with 100% O2
Succinylcholine available.
NEVER extubate a patient without an oral airway in place. AFTER you extubate a patient, suction the pharynx one more time, put the mask on the patient, keep your right hand on the bag, test for airway patency, and then help them breathe for a while.
2) reversed adequately: sustained tetany w/o fade > 5 sec is one way to do it.
3) vital signs stable
4) not in stage 2
Book stuff:
RSBI < 100. Respiration rate/tidal volume in Liters.
nif <-20mmhg (you can take off bag and cover hole with hand and have patient suck in while watching pressure gauge
leak test for airway surgeries/long prone case (dunno how useful it is in reality)
Extubation Criteria
| Head lift, Grip |
| NIF < -25 torr |
| RR < 30 |
| TV > 5 cc/kg |
| VC > 10 cc/kg |
| PaO2 > 65 on FiO2 < .40 |
| PaCO2 < 50 torr |
| Resting MV < 10 l/min |
| Level of Consciousness OK |
| Muscle Relaxants OK |
| TV/RR > 10 |
Patient either deep or awake
Patient either breathing or easy to ventilate manually
Oral airway in place
Pharynx suctioned
Cuff deflated
Lungs manually inflated with 100% O2
Succinylcholine available.
NEVER extubate a patient without an oral airway in place. AFTER you extubate a patient, suction the pharynx one more time, put the mask on the patient, keep your right hand on the bag, test for airway patency, and then help them breathe for a while.
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