You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A patient who was on ventilator and being ventilated for past few days, suddenly pulls out the endotracheal tube. What is the next step of management? and explain in detail?
Ans. a. Assess the patient, give bag and mask ventilation and look for spontaneous breathingIn self-extubation, assess the patient, give bag and mask ventilation and look for spontaneous breathing.Unplanned ExtubationUnplanned extubation of mechanically ventilated patients is relatively commonSelf-extubation refers to the patient's action, who deliberately removes the endotracheal tube (MC type of unplanned extubation, typically occur at night)Accidental extubation is attributed either to personnel's inappropriate manipulation of the tube during patient care or to a non-purposeful patient's action, e.g. coughing (mostly occur in the morning) Risk Factors for Unplanned ExtubationPatient factorsStaff factorsMaleDeliriumLight sedationDifficulty in securing tube (e g. facial swelling, facial burns)Previous unplanned extubationJunior staffNurse-to-patient ratioInadequately secured endotracheal tubeand/or checks