extubating

[MNNICU, RN]

Does this happen often with vented kids at your facility. It seems like whenever it happens at our facility some of the docs blame the nursing staff and say we are being careless. It hasn't happened to me yet but I don't take vented kids all that often. It makes me terrified to reposition them because I'm afraid they will extubate. We usually use neobars at our facility and actually had someone from that company come and show us how to measure and size them and apply them securely so I don't think that's an issue. Just curious if it's like an "oh yeah that happens some times" or a "that should never happen you screwed up" type of thing

[NICU Guy, BSN, RN]

We have an "Unplanned Etubation" form. We don't pass blame of who caused it, but what were the circumstances so if there is a pattern or cause (Loose tape or slobbery tape) then it can be addressed. If you have an issue with the security of the ETT, then call RT and get it re-taped. I have not had a baby that self-extubated, but if I did I would definitely push RT under the bus because it has to be their tape job that caused it. I am a super nurse and it can't be my fault.

[essT]

We also have a form to fill out after an unplanned extubation (and other events). The reaction depends on the practitioner, but it's usually an "it happens sometimes" response. Once the kid is stable, we talk about what happened.

We have one NNP who always placed blame until a baby extubated during her assessment -- never again! The baby was fine after, and it was slightly satisfying for all the RNs...

[BittyBabyGrower, MSN, RN]

We place a patient safety report. And kids extubate, it happens. Unless they are completely snowed, and are not slobbering it can happen. Especially big kids who grab the tube as soon as you let their hands loose and those little ones where a 1/4in can make a big difference.

[Janetnzrn]

In my country there are no RTs, we are responsible for retaping and suctioning. So unplanned extubation is pretty rare as we are directly responsible for the baby. We also are a really good team, so if there is any concern we get another nurse to help reposition. We are usually 1:1 or 1:2 with a vent and a cpap. But if we are 1:2 it can't be with a "grabby" baby! I like not working with RTs. Less layers to wade through to advocate and care for my babies.