Chapter 5: Self-Extubation
My book relates the harrowing experience when my husband pulled out his ventilator tube one night in the ICU.
It terrified us because Rick was critically ill, and we were completely uninformed about the risk of self-extubation. Now you have the information we wish we’d had.
Our doctor later clarified that self-extubation is not that uncommon. However, it is most certainly a potentially life-threatening event when it happens—someone absolutely needs to be at the bedside immediately assessing the patient. As long as such an event is responded to promptly, bad outcomes are typically avoided.
Click here for more information – Self-extubation in ICU patients.
“Self-extubation in ICU patients”, October 15, 2014, The Southwest Respiratory and Critical Care Chronicles.
Here’s what I learned:
My husband was a likely candidate for self-extubation because:
– He was a surgical patient older than sixty-five.
– He had prolonged immobility because he’d been on a ventilator for over a week already and was in the ICU for about a month.
– He had delirium.
– There is a higher likelihood of self-extubation among patients who are hours away from a planned extubation
– The study above suggests the importance of at least one nurse monitoring patients with these attributes at all times.
Other points to remember:
– The most common risk factor for self-extubation is inadequate sedation that leads to patient agitation.
– The frequency of self-extubation is higher the hour before and after shift change.