PITTSBURGH, PA – Hope Mercy ICU is starting a new policy that if you need your patient extubated just send them to radiology.
“Usually when your patient doesn’t quite meet extubation criteria but you have a feeling that they would do well without an endotracheal tube, just send them to radiology,” Dr. Wichman, a critical care physician, told GomerBlog.
“This policy works great, I don’t have to worry about being sued later because I extubated my patient when these arbitrary marks were not met. No more long paragraphs in my notes about why I was going on clinical intuition. Just send them downstairs and let it ride.”
For many years it was well known that an intubated patient sent to get a scan would lose their breathing tube somewhere along transport or in the scanner. About 40% of the time they would also lose their IV. “I would always report that the patient coughed out the tube or the IV got snagged; now there is this understanding that patients are coming down because they need their lines and tubes removed.”
No need to write an order for extubation or do weaning protocols. In fact if you don’t want your patient to receive any extra radiation, order an ultrasound or just ask for the off the menu item of “requesting radiologist to review the films with the patient.”
