Abstract:
Background: endotracheal extubation is defined as the removal of an endotracheal tube from the trachea. After extubation airway control is equally as important as securing the airway during anesthesia. Successful extubation should be the first priority for the anesthetist through checking the adequacy of breathing, verbal commands, full reversal of muscle relaxants and stabilizing of the vital signs.
Aim: the aim of this audit was to evaluate the quality of post anesthesia extubation practices in a specialized teaching hospital.
Materials and methods: this clinical audit was conducted from January 1 to February 30, 2019 in university of Gondar referral hospital. All patients who were undergoing surgery with general anesthesia in the study period were included. A data collection tools for this clinical audit were prepared based on different literatures recommendations. Statistical analysis: descriptive statistics were performed using SPSS version 20.
Results: a total of 90 patients were audited based on standards drawn from different literatures recommendations. The administration of 100% oxygen, suctioning and debris removal and reversal given before extubation were attaining 100 % of the audit standards. Extubation at the end of inspiration, initiation with reversals when the patient started to adequately breath and extubation of the patient when the patients can maintain saturation of ≥95% without oxygen source were attaining 60%,60% and 66.6% respectively. However, interruption of the anesthetic drugs after confirmation of the start of breathing, ensuring of the patient raising of arms ≥ 10 seconds from the operating table and head tilt ≥5 seconds and extubation of patients in left lateral position were attaining below 50% of the standards.
Conclusion: most of the quality indicators of post anesthesia extubation practices were below the average standards. So training should be given for all anesthetists who will be involved in day to day anesthesia practices and regular re-auditing should be done to attain the given standards.
Keywords: extubation, general anesthesia, clinical audit
