Preventing extubation COVID-19 Patient


How are you preventing patients from self-extubating? Is anyone routinely using wrist restraints as a preventative method?


Muscle relaxation as well as wrist restraints… if your facility is not using a HEPA filter at the end of the ETT… you run the risk of Covid becoming aerosolized

We are sedating patients deeper than we used it. And using intermittent muscle relaxants as bridges for them to work. And in those with HIGH sedation requirements yes for restraints.

In our institution we routinely use soft wrist restraints to prevent self extubation in addition to sedation requires to reach goal RASS score as discussed during daily round. In my experience it works fine but last week I had a confirmed COVID 19 patient(on vent 100%FIO2 and 14 PEEP) on soft wrist restrains, deep sedation and paralytic, despite of that he self extubated, luckily I was in the room and quickly reposition ET tube and patient did fine.

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