Factors leading to self-extubation of endotracheal tubes in the intensive care unit.
OBJECTIVE
To discuss the factors leading to self-extubation of endotracheal tubes (ETTs) and explore the differences between the groups of patients who did and did not self-remove their ETTs.


BACKGROUND
Self-extubation of ETTs has been reported to occur in 4.2% of severely ill patients and is associated with adverse medical effects.


METHODS
A case-control study.


METHODS
One hundred and thirty-nine subjects were recruited from a teaching hospital in southern Taiwan based on purposive sampling. The rate of self-extubation of ETTs was 6.4%. Analysis of the two groups demonstrated that significant variables were identified and fell into three categories: (1) the department to which the patient was admitted (p < 0.001), (2) whether the patient met the criteria for extubation (p < 0.001) and (3) the patient age (p < 0.05). Based on multiple logistic regression analysis, whether the patient met the criteria for extubation was a main variable that was associated with self-extubation of the ETT. Among the 44 patients who had self-extubation of their ETT, 28 met the criteria to be extubated, 70% and 81.8% of whom were not sedated, and self-extubation of their ETT was conscious of the act. Of the patients who attempted to self-remove their ETT, 80% were successful and 93.2% did not incur any adverse medical effects.


CONCLUSIONS
The medical doctor and nurse should fully evaluate a patient's oxygenation status, decrease the length of the extubation training session for patients and extubate patients promptly when extubation criteria are met.


CONCLUSIONS
Adopting a proactive approach to patient extubation will improve the overall quality of care.
Huang
Yuan-Ting
YT
Nursing Department, Kaohsiung Armed Forces General Hospital, Taiwan, China. hyt69145@hotmail.com
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012308:Risk Management; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D013624:Taiwan