Extubation protocol post CABG

[TravelRNBSN]

I am currently working in a CVICU and trying to get information from other facilities on their protocols and length of intubation post CABG. What is your goal to extubate on a stable patient? Under 4 hours? Do you use sedation? Is it nurse driven?

[gassy2be]

No sedation, RT and RN take equal roles, generally 4-6 hours but some go past the 6 hour mark.

[SubSippi]

Our goal is less than four hours. They are sedated initially, and we begin to wean them off as soon as their pressures are stable. Preparing the patient for extubation, and deciding when they will be extubated, is completely nurse driven. RT performs the actual extubation, but generally is not present unless the patient has wonky ABGs and/or is needing adjustments on the vent settings.

What are the policies at your facility?

[flymedicRN24, BSN, MSN, EMT-P, APRN]

Our goal is 4 hours or less. RN weans and extubates patient after blood gas while on CPAP and NIFF above 20 x2 without signs of respiratory distress.

[armyicurn]

No sedation, RT and RN take equal roles, generally 4-6 hours but some go past the 6 hour mark.

Ditto with the above but I was at a teaching hospital so the rest of the grey's anatomy team, aka residents were around clueless most of the time.

[dah doh, BSN, RN]

We aim for under 4 hr. It's nurse driven. I usually wake up stable pt after 2 sets of stable numbers & hemodynamics ok. We have a weaning protocol that the RT/RN follow. RT usually weans vent but RN can as well. If the pt meets the weaning parameters, RT extubates pt. If the pt doesn't meet the weaning parameters then it's a doctor's decision to extubate or not.