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Extubation in remote locations

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In keeping with the airway ideas today, I recently saw this awesome piece of information through #foamed (free open access medical education) on Twitter. Reposted by the gurus at LifeintheFastLane.com (awesome medical education blog) and originally developed by George Duros, this is a great new algorithm.

 

Now this may be a strange concept to most. Working remotely, sometimes patients are much better before the air-evac gets there to take the patient away to definitive care. This is exactly what this concept is designed for. The perfect scenario I might imagine to use this is a septic patient with poor pressures and altered status. Intubation early and a 24 hour wait time to evac the patient means the person may improve with a few doses of antibiotics, some fluids and a small run of pressure support. If this is the case, then why leave the tube in and risk complications of ventilator pneumonia, etc.

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