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Sat Jun 19 22:41:49 BST 2010

We have extinated a few.  I would say half need trached. Simply to  
protect airway

Sent from my iPhone

On Jun 19, 2010, at 3:43 PM, "Dan Burgess" <Dburgess at mhg.com> wrote:

> With the scenario you present I would question ability for the  
> patient to protect his airway if simply extubated
> Dan P Burgess RN MS CEN
> -----Original Message-----
> From: "Keith Lamb" <lambrrt at gmail.com>
> To: International Critical Care Medicine Group <ccm-l at list.pitt.edu>
> To: Respiratory Care Professionals World Forum <rc_world at listserv.iupui.edu 
> >
> To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
>
> Sent: 6/19/2010 2:03:21 PM
> Subject: Decompressive craniectomies
>
> How often do you see patients who have undergone decompressive  
> craniectomies
> eventually get extubated, NOT trached?
>
> We often do not extubate these folks even though we cannot  
> "pinpoint" a
> reason not to. They have good spontaneous respiratory parameters.  
> They have
> good intact airway reflexes, but they do not follow commands, and have
> minimal purposeful movement. The majority of ours wind up trached  
> without a
> trial of extubation.
>
> Experience?
>
> Keith
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