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Intubation/Extubation criteria?

Discussion in 'Anesthesiology' started by lymanite37, Apr 11, 2007.

  1. lymanite37

    lymanite37 New Member 10+ Year Member

    4
    0
    May 28, 2003
    San Antonio, TX
    I'm an MS-III doing an anesthesia rotation. The doctor I was working with yesterday asked me to research and present to him the criteria for intubation/extubation. I've looked and can't really find anything official. I'm guessing he wants me to tell him what I should see on the monitors and from the pt. before I attempt to intubate/extubate. Is there an official list of criteria for this? Thanks.
     
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  3. IceDoc

    IceDoc Junior Member 10+ Year Member

    114
    4
    Mar 4, 2005
    Almost any critical care textbook will have a chapter about these issues. For extubation, be sure to include objective indices such as the Rapid Shallow Breathing Index (the other RSI), NIF and other "mechanics", etc...
     
  4. VentdependenT

    VentdependenT You didnt build thaT Physician Moderator Emeritus 10+ Year Member

    4,011
    18
    Oct 3, 2003
    Louisville
    other than "I think he'll be ok" make sure:
    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)

    TV >10cc/kg
    VC > 15cc/kg
    Spo2 > 90% with fio2 <40%
    RR <35
    paco2 <45

    something about dead space which I aint calculating in the OR and something about shunt being less than 15%...again, I ain't calculating it. A-a gradient can also be used in some capacity.

    You can always ask the patient...
     
  5. VolatileAgent

    VolatileAgent Livin' the dream 7+ Year Member

    1,039
    1
    Jul 6, 2005
    pull it deep.
     

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