Hi there!
Today’s article is about, “Quick Tip for Families
in Intensive Care: What are the Risks to Remove the Breathing Tube? (Extubation)”
You may also watch this through this YouTube link https://youtu.be/VTt7mLadkYk or you can continue reading the article below.
Quick Tip for Families in Intensive Care: What are the Risks to Remove the Breathing Tube? (Extubation)
Hi,
it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So today, I want to focus on, “What are the risks for removal of the breathing tube, also known as extubation?” Extubation is the medical term for removal of the breathing tube. So, there are a number of risks and I have talked about this before that when you remove the breathing
tube or you extubate the patient, it’s like you have a limited window of opportunity and you need to choose that window wisely working up towards an extubation or removal of the breathing tube.
Have a look at another one of my videos where I talk about, “How to wean a critically ill patient off the breathing tube and the ventilator?” I will link towards that below this video. Now, I’m not going to talk here today about how to get ready for extubation because that’s all covered in that other video.
So today, I really want to focus about, “What are the risks after extubation has taken place?” One of the biggest risks is obviously respiratory failure. People stop breathing right
away or they breathe too shallow, they breathe too fast, their oxygen saturation levels are dropping down. They might end up with a stridor. If they end up with a stridor, you got to put a nebulizer on either an adrenaline or epinephrine nebulizer or potentially give steroids, use BIPAP (bilevel positive airway pressure), CPAP
(continuous positive airway pressure), high flow nasal prongs, potentially using a cough assist machine. Those are all ways to potentially avoid a reintubation and intubation means putting back a breathing tube.
So, other risks are aspiration. So, if you give a patient after extubation, after the removal of a breathing tube, if you give them food or water too early, and they start vomiting and throwing up, that puts them at risk of aspiration, especially if there’s issues around swallowing.
What else is important that you start mobilizing a patient as early as possible, that you start giving them physical therapy, that you do breathing exercises with them, coughing exercises. It’s very important that an extubated patient can protect and
maintain their own airway. So, it’s very important that after extubation, your loved one sits upright, straightened up so that they can breathe properly.
It’s also very important that the intensive care team assesses post extubation, arterial blood gases to see what oxygen levels and carbon dioxide levels in the blood are. A chest X-ray can be very helpful, making sure that the lungs stay expanded and are not collapsing.
So, it’s also important obviously that you keep assessing conscious levels, especially if someone has been in an
induced coma for prolonged periods. They might get too drowsy, too quickly. You might have to use an antidote to keep people awake and wake them up, continuous monitoring is really, really important in those situations.
What happens if extubation fails? Following things can happen: A patient needs to be reintubated, i.e., needs the breathing tube back in and be put back on the ventilator. That would be the worst-case scenario and should be avoided at all costs and then those patients sometimes end up with a tracheostomy. But I’ve covered, “When your loved one needs to tracheostomy?” in many, many other videos. So, I again, I’m not going into detail today.
Today, I just wanted to cover what are the risks after extubation or after removal of the breathing tube. If you have any other questions around the topic, please
comment below the video and I will answer them.
Now, if you have other questions when you have a loved one in intensive care, we have a membership for families of critically ill patients in intensive care where we answer your question. In the membership, you have access to me and my team, 24 hours a day, via email and in the membership area and we answer all questions intensive care related as it
relates to your loved one. You get access to the membership when you go to intensivecarehotline.com by clicking on the membership link or if you go to intensivecaresupport.org directly.
I also offer one-on-one consulting and advocacy for families in intensive care over the phone, via Zoom, WhatsApp, Skype, whichever medium works best for you. I talk to doctors and nurses directly. I talk to you and your families directly. When I talk to doctors and nurses directly, I ask all the questions that you haven’t even considered asking but must be asked so that you can make informed decisions have peace of mind,
control, power, and influence.
I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over 5 years. I have been consulting and advocating for families in intensive care all around the world for the last 10 years here at intensivecarehotline.com. Have a look at our testimonial section as well as some of our client podcasts to verify the outcomes that we’re getting for clients including
having saved lives.
I also represent you in family meetings with intensive care teams so that you have a strategy. Do not go into family meetings with intensive care team without having a strategy. You don’t know what’s to come there. I’ve been in hundreds of those family meetings with intensive care teams, I know what’s to come. By working with me one-on-one, we remember how to strategize, how to
get into the meeting, whether you should even go into the meeting, which is a very important consideration that most families in intensive care don’t even have on the radar, and it is a consideration.
We also offer medical
record reviews in real time so that you can get a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.
All of that you get at intensivecarehotline.com. Call us on one of the numbers on
the top of our website or send us an email to support@intensivecarehotline.com.
Now, if you like my videos, subscribe to my YouTube channel for regular updates for
families in intensive care. I also do a weekly YouTube live where you can ask me questions live on the show, click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have.
Thanks for watching.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for now.
