Awake Extubation Case Study
Management and outcome
The surgery was successful. The anaesthetist told me he will be like to do awake extubation because patient was grade 2 view on intubation. This method is used to perform an extubation once the patient is fully awake and able to maintain his own airway (e SAFE, 2017) I prepared for awake extubation, all the airway equipment for the intubation were kept for anaesthetic emergence, guedel, laryngoscope, bougie, 20ml syringe. (REF must not be thrown away) .I place an Inco - pad on the chest of the patient for the anaesthetist to put the removed tube, for cleanliness and to prevent infection (REF).
Prior to the extubation of the patient, the Anaesthetist checked the patient’s response to verbal command and recalled after
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The anaesthetist removed the ETT and proceeded to place a tight fitted mask on patients face. (REF)She then alerted the team that there was a problem with the patient airway (REF). The mask did not mist up – indicating of no air movement return, there was no carbon dioxide trace on the capnography and the patient oxygen saturation dropped steadily from 100% to 90%. He instigated vigorous jaw thrust to improve oxygenation, and using continuous positive airway pressure(CPAP) to deliver 100% oxygen flow through the breathing bag attached to the anaesthetic machine but all this effort was not having any effect on the ventilation. He then asked my mentor the Operating Department Practitioner (ODP) to administer 50mg/5ml of intravenous Propofol. An open airway was established within minute which confirmed the anaesthetist suspected diagnosis that the patient had a severe laryngospasm and the anaesthetic effect relaxed the patient’s vocal cords.( REF algorithm of Laryngospasm)DAS
Laryngospasm is a condition where vocal cord suddenly seized up. It is defined as an acute glottis closure by the vocal cord (Oxford Handbook of Anaesthesia, 2006,). There is the closure of the vocal cord when taking a breath from irritation, blocking the flow of air into the lungs.
The pathophysiology of laryngospasm is the primitive protective
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