Difficult extubation

 

Difficult extubation refers to anticipated or unanticipated difficulties with breathing and oxygenation after extubation, especially scenarios where there might be a need to re-intubate a patient.

The UK's Difficult Airway Society (DAS) has produced three algorithms for the management of extubation, a basic, a low-risk and an 'at risk' strategy. They are available for download from their (fantastic) website.

1. The 'basic' algorithm:

Reproduced from Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia 2012; 67: 318–340, with permission from the Association of Anaesthetists of Great Britain & Ireland/Blackwell Publishing Ltd

2. The 'low risk' algorithm:

Reproduced from Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia 2012; 67: 318–340, with permission from the Association of Anaesthetists of Great Britain & Ireland/Blackwell Publishing Ltd

3. The 'at risk' algorhithm:

Reproduced from Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia 2012; 67: 318–340, with permission from the Association of Anaesthetists of Great Britain & Ireland/Blackwell Publishing Ltd

 

REFERENCES

Karmarkar, Swati; Varshney, Seema (2008): Tracheal extubation. In Continuing Education in Anaesthesia Critical Care & Pain 8 (6), pp. 214–220. DOI: 10.1093/bjaceaccp/mkn036.

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