Session Key Points

A sequence of events precedes successful extubation. Your checklist should include the following:

• Neuromuscular function must be brought back to normal. A nerve stimulator will help you. Administer appropriate reversal agents
• Discontinue your anaesthetic drugs and give 100 % oxygen at 6 L/min
• Carefully apply suction to the patient’s airway
• Check that the patient is breathing adequately. Insert a Guedel airway if appropriate
• Place the patient in a safe recovery position
• Assess the patient’s wakefulness, extubate when appropriate, and continue oxygen into the recovery room
• Always be prepared in case re-intubation is required – although uncommon, it may occur as an emergency and you should be ready with drugs and equipment near at hand