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Chest, Vol 98, 165-169, Copyright © 1990 by American College of Chest Physicians

ARTICLES

Self-extubations. A 12-month experience

DP Coppolo and JJ May
Mary Imogene Bassett Hospital, Cooperstown, NY 13326.

Unplanned removal of an endotracheal airway tube by a patient (SXT) represents a potentially life-threatening incident. Prospective monitoring of all intubated adult ICU patients for one year revealed that 12 of 112 extubated themselves (overall incidence, 11 percent). Comparison of SXT patients with the NXT group disclosed no risk factors for this occurrence. The proportion of patient-hours was similar when both groups were examined for tube size, tube site, ventilation mode and ventilator type. The mean hours of intubation was lower in the SXT group. Sixty-nine percent of unplanned extubations were deliberate; the majority of these occurred despite use of sedation and restraints. No death resulted from these events. The complication (and reintubation) rate in the SXT group was 31 percent. The reintubation rate in deliberate extubations was 11 percent. Self-extubation is a common occurrence which, despite obvious hazards, often is tolerated well by adults.


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Copyright © 1990 by the American College of Chest Physicians.