Extubation

Definition: the removal of the tracheal tube ETT
Requirements:
1) Patients are aware or to cough effectively
2) stable vital signs and no hypoxia
3) sedative medications are minimal and not influenced by muscle relaxan
4) Tidal volume of patients over 5cc/kg
5) the underlying disease in patients for intubation improved
Objectives:
1) As the final stage and the process of weaning from ventilator
2) In order for the patient to breathe spontaneously
3) In order for the patient to cough effectively and can issue its own sputum

Procedure:
1. Preparation Equipment:
• Set full suction
• suction catheter
• O2 NRM
• Set intubation
• Gloves
• Spuit 20 ml
• Drugs and inhalation premediakasi physician orders
• Spirometry
• Emergency trolly
2. Implementation
a) Nurses wash their hands and wear gloves
b) Inform and explain if the patient is unconscious) regarding the actions taken
c) Monitor vital signs (stable)
d) Patients fasted
e) Check AGD
f) Check the tidal volume by spirometry
g) NGT flowed with plastic bags
h) Give pre-medication drugs as directed, onat inhalation, adrenaline + NaCl 0.9% or Ventolin and pulmicort, such as the type of corticosteroid injection drug
i) Perform suction mucus through the mouth and clean ETT
j) Cuff dikempeskan
k) ETT fixation patch released
l) Time of appointment ETT, suction hose must exist in the ETT to suck mucus until the ETT in drag
m) Perform suction through the mouth
n) Install the NRM 10 lpm O2
o) Position the patient semi-Fowler and give appropriate instructions inhalation therapy
p) Tidy tool
q) The nurse took off the gloves and wash hands
r) Observation of vital signs and 1 hour and then re-check AGD