extubating for terminal patient

[verock]

Hello, just wondering what are the standard practices when extubating a pt who is terminally ill. My family member is in multiple organ failure, and currently has been intubated for 2+ weeks. We know that she would not want to be kept on a ventilator and we know this is prolonging her time here. We have decided to extubate her since there is nothing else that can be done. I would also like to know what to expect once this is done, at times she opens her eyes but no one is sure if she is aware or has any brain function. Thank you so much..

[GardenDove]

My husband was extubated and died later that day. He was in multisystem failure due to his lymphoma. He did not wake up, I believe he had been oxygen deprived, he most likely threw a clot and had a PE, a side effect from his chemo. He wasn't supposed to have been intubated in the first place.

They remove the tube and then put them on a mask, I think they put him on a non-rebreather. It's pretty simple, but terrible and sad.

[aimeee, BSN, RN]

I'm sorry to hear that you are experiencing this with a family member. It is a difficult decision. Its very difficult to say what will happen after extubation. Sometimes patients surprise us. Here are a couple pages describing a particular protocol. This will differ somewhat depending on your facility and circumstances.

http://www.eperc.mcw.edu/fastFact/ff_035.htm

http://www.eperc.mcw.edu/fastFact/ff_033.htm

http://www.eperc.mcw.edu/fastFact/ff_034.htm

[a21chdchic]

Why was the tube placed? And how could anyone call this comfort care? Can anyone that has ever seen an intubation or cared for an intubated patient say that this is comfortabe? When the patient isn't sedated, if they have a gag reflex, they are gagging! Plus, it must be very traumatic for the patient!

Let me guess, the family had a panic attack, sent the patient to ED?

Ana

[a21chdchic]

OOPS, traumatic for the family.

Ana

[doodlemom]

Hello, just wondering what are the standard practices when extubating a pt who is terminally ill. My family member is in multiple organ failure, and currently has been intubated for 2+ weeks. We know that she would not want to be kept on a ventilator and we know this is prolonging her time here. We have decided to extubate her since there is nothing else that can be done. I would also like to know what to expect once this is done, at times she opens her eyes but no one is sure if she is aware or has any brain function. Thank you so much..

We frequently get involved when a family is considering extubation. We usually have the patient on a morphine drip for comfort. Patient's sometimes die within a few minutes and many live for several hours to several days. We occasionally have patient's that do "well" and are able to leave the hospital or our hospice facility to have care at home or nursing facility. My heart goes out to you and your family, as I know this must be very difficult.