sun7777

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Does anyone have any tips for smooth extubations (no bucking)?
 

militarymd

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sun7777 said:
Does anyone have any tips for smooth extubations (no bucking)?
deep extubation
 

sun7777

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Actually, I meant tips for extubation other than deep extubation. I have heard you can give iv lido but it seems hard to time properly given that some pts start to buck early and others later. I have also heard that you can try to titrate in narc at the end, but doing so may prevent the patient from breathing. I have also heard of people modifying the ET tube in order to administer topical lido to the cords but modifying every ET tube seems impractical. Is there an easy way to use LTA at the end of the case?
 
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Noyac

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sun7777 said:
Does anyone have any tips for smooth extubations (no bucking)?

More practice. Everyone has pts buck from time to ttime. I seem to have less and less every year. Sorry but there are no surefire tricks to prevent everyone from bucking (except the deep extubation one).
 

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sun7777 said:
Actually, I meant tips for extubation other than deep extubation. I have heard you can give iv lido but it seems hard to time properly given that some pts start to buck early and others later. I have also heard that you can try to titrate in narc at the end, but doing so may prevent the patient from breathing. I have also heard of people modifying the ET tube in order to administer topical lido to the cords but modifying every ET tube seems impractical. Is there an easy way to use LTA at the end of the case?

I think a really good way is (if you have time) to titrate in narcotics until they are breathing 12-15 times a minutes. This can help.
 
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