Accidental Extubation

[twizzlers67]

Hello all, I'm a new nurse in the nicu (still on orientation) and I was wondering what to do if my patient self-extubates. I understand that if my patient's sats are hanging in the 40s and there's no audible breath sounds/chest rise I can assume the tube's slipped out of the trachea and I should bag with O2. But should I just pull the ET tube out? and if I do pull it out won't it still be taped to the lip/face and get in the way when I am trying to get a good seal with the bag and mask? I cant imagine taking the time to gently pull the tape off of the kid's face but at the same time I know it would get in the way while trying to bag. I'm just a little confused about this and the events that follow. I'm so nervous that my vented patient will jerk his head in the wrong direction and I won't know how to react! If anyone could shine some light on how they handle an accidental extubation it'd be a huge help!

[UTVOL3]

For all you neobar users, please be aware that there is a little "notch" on each side of the bar where it meets the duoderm that you can literally cut with scissors in the case of an emergency! if the neobar is on correctly, you should have enough space between the baby's face and the bar to slip scisors in. yes you have to be careful, but it is still faster than ripping the tape off!!

Yep, the "notch" i couldn't figure out how to word it. Thanks!