Extubation in the Emergency Department and Resuscitative Unit Setting

Emerg Med Clin North Am. 2019 Aug;37(3):557-568. doi: 10.1016/j.emc.2019.03.004. Epub 2019 May 21.

Abstract

A subset of intubated patients can safely be extubated in the emergency department (ED). The emergency medicine provider should be prepared for both common and life-threatening complications if considering ED extubation. Patients selected for extubation in the ED should have a low or near zero risk of reintubation or extubation failure. Intensive nursing care, close monitoring, and the ability to reintubate are minimum requirements for EDs considering ED extubation. This article provides a framework for determining appropriate patients for extubation and a practical approach on how to safely perform the procedure.

Keywords: ED Extubation; Emergency Department Critical Care; Resuscitation.

Publication types

  • Review

MeSH terms

  • Airway Extubation / methods*
  • Blood Pressure
  • Delirium / complications
  • Emergency Service, Hospital*
  • Heart Rate
  • Hemodynamics
  • Humans
  • Hypoxia / etiology
  • Hypoxia / prevention & control
  • Neurologic Examination
  • Oxygen / blood
  • Palliative Care
  • Patient Selection
  • Psychomotor Agitation / complications
  • Respiratory Rate
  • Respiratory Sounds
  • Risk Assessment
  • Ventilator Weaning

Substances

  • Oxygen