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If you want to know when a breathing tube needs to be put back in after extubation or removal of the breathing tube, stay tuned! I’ll have news for you.

Hi, my name is Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care. So, today I have a question from a client of ours who says, “When does the breathing tube need to be put back in after extubation?” Extubation means the taking out or the removal of the breathing tube when someone is mechanically ventilated with the breathing tube in their mouth that goes down into the lungs.

So, the situation is as follows, that our client’s son is in ICU, and he is ready to be extubated, but he’s worried that the breathing tube needs to be put back in, and that is certainly a concern for many patients that move towards extubation. You need to have a plan to avoid reintubation, but what are the signs? I want to break that down today specifically.

So, signs that the breathing tube needs to be put back in is high prolonged breathing rate about 30 breaths per minute. So, the faster someone is breathing, the higher chances are they’re not getting enough oxygen.

Another sign is shallow breathing. So, if someone is breathing shallow and also is using their accessory muscles, like their tummy muscles, instead of using their respiratory muscles.

Next is shortness of breath if someone is finding it hard to breathe.

Another sign is if oxygen saturation is less than 94% and it’s prolonged. It’s not a problem if it’s only for a couple of seconds or for a few seconds, even if it’s only for a few minutes, a patient often might just need some repositioning, get in a better position to breathe. So, it’s not only a case of looking at numbers, it’s also a case of what can be done to improve those numbers.

Next is, if there’s an inability to clear secretion. So, what that means is, if someone can’t clear their airway, they can’t cough, they can’t bring up their phlegm, they can’t bring up their secretions, and can’t spit it out; that is also a risk that the breathing tube needs to be put back in.

Next, if someone is unconscious and has an inability to breathe, of course, or has an inability to cough, or a gag because of their unconsciousness.

Next, if arterial or capillary blood gases are out of range, that means if PO2 (partial pressure of oxygen), which is oxygen in the arteries is too low, or if PCO2 (partial pressure of carbon dioxide) is too low. PCO2 is the carbon dioxide. I encourage you to check on our section at intensivecarehotline.com about arterial blood gases and I’ll put the link below this video.

Also, when the breathing tube is taken out, i.e. extubation, and someone is struggling, another way to avoid the breathing tube to be put back in is to use BIPAP (Bilevel Positive Airway Pressure)/CPAP (Continuous Positive Airway Pressure) ventilation with the mask or high flow nasal cannula or also chest physiotherapy.

So, those are the signs when a breathing tube needs to be put back in, which is also known as intubation.

Now, I have worked in critical care nursing for nearly 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care here at intensivecarehotline.com since 2013. I can confidently and without the slightest hint of exaggeration, say that we have saved many lives, prolonged many lives with our consulting and advocacy, giving families and our clients the tools and the strategies to make that happen. I’m talking to doctors and nurses directly in intensive care, advocating for our clients.

You can also verify what I’m saying here on our testimonial section at intensivecarehotline.com or on our podcast section where we’ve done client interviews at intensivecarehotline.com.

It’s also one of the reasons why we have made a membership available for families of critically ill patients in intensive care and you can become a member if you go to intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related.

In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded and share all my experience from decades of intensive care nursing, working with thousands of patients and their families directly in intensive care or here with intensivecarehotline.com. And I’m not holding back, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment. You can’t steer this incredibly difficult environment, intensive care, by yourself. You are in a once in a lifetime situation that you simply can’t afford to get wrong.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through the experience. I also talk to doctors and nurses directly and I ask all the questions of the doctors and nurses that you haven’t even considered asking but must be asked when you have a loved one critically in intensive care.

I also represent you in family meetings with intensive care teams.

We also offer medical record reviews in real time so that you can get a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have, and share this video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on the show and you can become a subscriber. If you become a subscriber of my YouTube channel, you will get notification for that or if you become a subscriber of our email newsletter at intensivecarehotline.com, you will get notification for the YouTube live.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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