Extubation and Decannulation

1.  Wash hands and don personal protective equipment.

2.  Hyperoxygenate and suction endotracheal tube and pharynx.

3.  Deflate cuff if present and inflated.

4.  Cut twill tape or remove tape to free tube.

5.  Instruct patient to breathe deeply.

6.  While the tube is being removed, at the peak of inspiration, monitor and support the patient.

7.  Encourage the patient to breathe deeply and cough.

8.  Suction the pharynx.

9.  Apply supplemental oxygen and aerosol, as appropriate.

10. Place a dry, sterile, 4 x 4 dressing over stoma when tracheostomy tube is removed.

11. Document in patient record.