extubation

Question 1

list the indication for weaning a patient’s MV?

Answer 1

1. ) partial/total reversal condition
2. ) lung baseline function (muscle strength)
3. ) adequate ventilation and O2 (already on low Fio2 ventilation)
4. ) good cardio vascular status ( perfusing normally)
5. ) good major organ function ( kidney filtration, heart )
6. ) no psychological issue- ICU Sycosis, wake appropriate

Question 2

list the indications for extubating

Answer 2

1. ) pt does not require mechanical ventilation
2. ) pt can clear secretions
3. ) pt has gag reflex
   - no upper airway obstruction or swelling

Question 3

list materials need it for an extubating procedure

Answer 3

-blue pad
-suction equipment *yaunker ,pinky, set reg to 120mmhg
bagger and mask (right size)
- OPA
scissors
1;1000 epinephrine(5cc nebulized for post extubation stridor)

Question 4

describe an assessment of a cuff leak

Answer 4

1.) drop cuff, listen for audible leak during PPV breath. or you could measure difference btw insp and exp volumes with cuff down. input tidal volume deliver (400mls) which should have an acceptable leak of 105mls. other volumes > 20 %

Question 5

what position should be the patient in while extubating ?

Answer 5

the patient should be in semi/ high fowlers, easier for patient to cough

Question 6

how is stridor alleviated post extubation ?

Answer 6

use 1:1000 epinephrine to vasoconstrict and reduce inflammation