The idea of self extubating sounds cray cray, appa

The idea of self extubating sounds cray cray, apparently it is way more common than we may think. I will pray for the patient who pulled his own tube and hope he was lucid and in a good health when he pulled it, yikes.

Great day to be long CYDY...

<<Self-extubation is a common event in the intensive care units (ICUs) throughout the world. The presence of an endotracheal tube is a constant strong irritant for the patient. From a clinician's perspective, providing analgesia and sedation for preventing self-extubation is a double-edged sword. On one hand, adequate sedation can easily prevent self-extubation; however, at a cost of increased incidence of ventilator associated pneumonia (VAP)[1] and increased mechanical ventilatory days.[2] On the other hand, light sedation prevents the above complications but is likely to be associated with higher rates of self-extubation and patient agitation.[3] A light plane of sedation can lead to severe ventilator patient asynchrony and defeat the purpose to ventilatory support itself.>>

Achieving optimal sedation is an idealistic goal; however, due to inter-patient variation of required doses of sedatives, titration has always been difficult. The nature and degree of sedation is governed by the neurological and hemodynamic status of the patient. In terms of intubated patient sedation should be enough so that the patient tolerates the endotracheal tube without becoming unresponsive. Prevention of self-extubation in limited sedation by use of restriction of patient limb movements may have ethical concerns. Attitude and alertness of medical and para-medical staff can have a major influence on preventing self-extubation related catastrophes. In the present retrospective study, we evaluated various factors influencing the self-extubation of patients in a medical/surgical ICU of a tertiary care center during a period of 1 year.