Home Internal Medicine Critical Care Tip: If You Need to Extubate Patient, Send to Radiology

Tip: If You Need to Extubate Patient, Send to Radiology

Lord Lockwell
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46
An extubation just waiting to happen

PITTSBURGH, PA – Hope Mercy ICU is starting a new policy that if you need your patient extubated just send them to radiology.

Radiology scanner
An extubation just waiting to happen

“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.”

46 COMMENTS

  10. Not sure what kind of training these transport people have, but our hospital has specific critical transport teams for intubated patients to procedure areas, and very well trained Radiology nurses in all areas of Radiology. Not sure of our stats, but am damn sure it’s not 40% extubation rate. That’s ridiculous. Obviously many hospitals need to wake up and pay for more training and better staff in Radiology areas. Ours does and patient safety is paramount!!!!

  11. I know! These incidents happen everytime! As soon as the R.N. who by the way, is the primary individual responsible for the patient, arrives to the scanner and as soon the patient is transferred from the bed to the CT table, plops his or her ass on the chair behind the control screen and has his or her face buried on the iphone. Especially when the patient is moving in and out of a scanner, while the respiratory therapist is bagging and trying to keep up with the patient moving in and out of the gantry

  15. Que marmota!!! Kkkkkkk de fato eles tem mania de acordarem no meio do caminho quando a gente pede uma TC por rebaix de sensório kkkkk
    Mas perder tubo… Nunca acontece não rs… Esse povo deve estar com tubo sem necessidade rs

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