Policy for extubation of critically ill patient in theatre

Author: Dr. Greg Sund

• Date: 9 March, 2023

• Version 1

Purpose: The purpose of this policy is to ensure appropriate communication between relevant members of the anesthesia team in coordination with the surgical team when deciding whether to extubate critically ill patients at the end of a surgical intervention.

Protocol: For any critically ill patient undergoing a surgical intervention at AIC Kijabe Hospital, the decision whether to extubate will be made by at least three parties, those being:

• the anesthetist caring for the patient,
• the consultant anesthetist and
• at least one member of the surgical team.

A critically ill patient is any patient who is ASA 4 or 5 or who will need postoperative monitoring in the intensive care unit (ICU) or high- dependency unit (HDU). The members of the team involved in making this decision should be documented in the anesthetic record. If questions about the appropriateness of extubation remain after discussion with the above team, the ICU consultant may be engaged to help advise.