Extubation
Procedure
All equipment required at intubation is required at extubation in case rapid re-intubation is needed.
IV access essential - check before extubating
Have vial of propofol and vial of vecuronium ready to use by bedside
Post extubation stridor
nebulised adrenaline 0.5ml/kg 1 in 1000 (max 5ml)
and dexamethasone 0.5mg/kg IV (max 10mg).
Prophylaxis against post extubation stridor
Used in patients with history of failed extubation due to upper airway obstruction, and in some ENT cases
Dexamethasone: 0.5mg/kg IV qds (max 10mg) Start 6 - 12 hours prior to extubation, up to 6 doses may be given.
A lower dose is sometimes given at Consultant's discretion.
Monitor glucose and BP carefully.