Method

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT

Apply positive pressure

Remove ETT

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient
Suction the patient’s oropharynx under direct vision to ensure it is clear of debris. This will reduce the risk of aspiration and laryngospasm. If you intend to extubate when the patient is awake, it is sometimes useful to insert a bite block.

Oxygen via ETT

Untie ETT

Apply positive pressure

Remove ETT

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 1

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT
Continue the administration of 100% oxygen to the patient.

Untie ETT

Apply positive pressure

Remove ETT

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 2 100 % oxygen at high flow

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT
Untie the endotracheal tube and deflate the cuff.

Apply positive pressure

Remove ETT

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 3 Cuff being deflated

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT

Apply positive pressure
Apply a small amount of positive pressure to the reservoir bag and remove the endotracheal tube.

Remove ETT

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 4 Reservoir bag

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT

Apply positive pressure

Remove ETT
The patient will breathe out and clear any remaining secretions.

Suction again

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 5 Patient breathing out

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT

Apply positive pressure

Remove ETT

Suction again
It may be necessary to perform suction to further clear any remaining secretions from the back of the oropharynx.

Oxygen via face mask

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.

Fig 6 Suction equipment

Whether the patient is awake or deep, the process of extubation is similar and includes the following steps:

Suction the patient

Oxygen via ETT

Untie ETT

Apply positive pressure

Remove ETT

Suction again

Oxygen via face mask
Apply 100 % oxygen via face mask.

In general, the patient’s airway is safest when the endotracheal tube is in place. After it is removed, the patient may then be at risk of airway complications, which will be discussed in the remaining part of this session.