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Extubation

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Looking for stories on quick extubation or what criteria needs to be in place for extubation.

Recently had a patient who received a new cancer treatment. Shortly after his infusion started he went into cardiac arrest. We performed cpr, defibrillated him 3 times, intubated him and got him back. He was in the cancer center and by the time he got back to the ED he was fully awake and making eye contact, following commands and had purposeful movement. We quickly sedated and paralyzed him since he didn’t get any while being intubated since he was unresponsive. If he was hemodynamically stable would we extubate? He wasn’t BP 70/40 and he was put on pressors and sent to the ICU but I was just curious if anyone has ever extubated quickly after an emergent situation with a patient improving rapidly.

Similar cases

65yr female admitted into ICU post multitrauma mainly chest . She had weaning failures and failed extubations. She was found to have diaphragmatic tear after CT sinogram which was one of main reasons for extubation failure. Finally got her diaphragm repaired. Hoping for successful extubation this time. CXR post and pre diaphragm repair.

this 7 year old child was emergently intubated following a febrile seizure. He was extubated after several days and then had persistent biphasic strider. Bronchoscopy showed subglottic eschar. This was adherent and had to be removed under micro-direct laryngoscopy with small cup forceps. The area was also dilated with s balloon. The patient became asymptomatic.

Patient transferred from Critical care with known DVTs. On Bi-pap 50% 16 over 10. Was at first able to walk into bed. Hours later was air hungry and wanted to sit in chair. The patient proceeded to lay on the floor (by herself) and we got her back into bed. The best SpO2 would could get was 75. Her hands had nail polish and we tried multiple areas for a reading. Had lots of trouble due to various factors. She proceeded to go into a wide complex tachycardia and arrested. We tried intimating multiple times and after hours of coding had to call it. This was her ABG after intubation. Thoughts?

Whilst we all love a nice sterile environment to work in, sometimes you just have to make do with what you've got. This casualty had found himself on the wrong end of an enemy knife and had sustained some significant lacerations to his chest, arm and back. Fortunately the underlying lung seemed clinically undamaged and he was saturating well on room air. Our element was moving quickly through the area but I managed to get a 15 minute pause to suture him up a bit and give him a good dose of IV antibiotics. I had no way of following him up, but hopefully he did well.