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Flashcards in Vent-Extubation Deck (11):
1

Important Questions in Regards to Extubation 

  • Is patient getting better?
  • Is initial reason for providing ventilatory support resolved or improved?
  • Does the patient requires minimal ventilatory support
  • Is patient clinically stable?
  • Is there any impending condition that might require airway support?
  • Is patient  able to protect airway/ Manage oral secretions
  • Is patient requiring minimal suctioning/Adequate cough

2

Clinically Stable-CNS and Psychological Factors 

Adequate CNS function needed to maintain stable ventilatory drive, adequate cough and ability to manage oral secretions

LOC, anxiety, depression and dyspnea can all have an impact on weaning success

3

Clinically Stable-Evaluation Of The Airway

 

Patient’s ability to maintain patent airway

Risk of aspiration

4

Clinically Stable-Oxygenation 

FiO2, PO2, lactic acidosis

P/F Ratio (>300)

 

5

Clinically Stable-Ventilation and acid-base balance 

pH, PCO2, VT, f spon, RSBI

6

Clinically Stable

VC

7

Clinically Stable-Respiratory Muscle Strength

MIP or NIF (-20cmH2O)

8

Clinically Stable-WOB

thoracic cage movement , accessory muscle use, irregular ventilatory pattern during spontaneous breathing

 

 

9

Clinically Stable-Stable vital signs and hemodynamic parameters

HR, BP, CO etc.

 

 

10

Clinically Stable-Optimum nutritional status

functioning G.I. Tract

 

 

11

When extubated you need to watch for signs of ventiatory failure whcih include

Decrease SpO2

Increase FiO2

Increase WOB

Decrease LOC