# @thecrnaclub on Instagram

- **Type:** Image
- **Original URL:** https://www.instagram.com/p/Cto8Fu-MMZf
- **Gondola URL:** https://gondola.cc/posts/77095978-thecrnaclub-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/2e6d430f1b.jpg
- **Posted:** 2023-06-18T17:12:57.000+00:00
- **Account Owner:** Community for aspiring CRNAs (@thecrnaclub) — https://gondola.cc/thecrnaclub

## Caption

👉 So, how does extubation in the ICU differ from extubation in the OR? ⁠
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Well, a big one is the speed at which the "weaning" process occurs. In the OR, we don't really even think of this so much as a weaning process, because patients typically don't become dependent on the ventilator (unless we give them muscle relaxant, but we can reverse that pretty quickly). We typically think of this more as, "let's get them back breathing spontaneously" type of process. ⁠
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In the ICU, patients are suuuuuper deconditioned. We worry about strength, about ability to keep that CO2 down. They've been laying that in that ICU bed for days, weeks, months even. The weaning process is a lot more gentle. ⁠
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In the OR, we still are looking for the same key indicators of ability to maintain adequate ventilation: CO2, Minute Ventilation, RR, and strength. We also look at mental status as well. We just tend to do it a lot quicker. ⁠
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We also are less concerned about patients "tiring out". We worry more about complications during wake up (emergence) that could arise as a result of the surgical experience. Emboli, fluid overload, larygospasm, bronchospasm, bleeding. ⁠
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We also care a lot more about coughing. In the OR, no neurosurgeon or ENT surgeon wants the patient coughing a ton during wakeup, and increasing ICP or increasing pressure on their surgical sites and testing the strength of their sutures! ⁠
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What other differences do you notice (SRNAs feel free to chime in!) about extubating in the ICU vs OR? ⁠
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#srna #crna #dnpcrna #crnaschool #rn #rntosrna #srnatocrna #crnajourney #futurecrna #nurse⁠
#nurses #nurselife #ignurses #nursesofinstagram #nursingschool #nursingstudent #anesthesiaschool #anesthesia #anesthetist #anesthesiology #nurseanesthetist #nurseanesthesiologist #nurseanesthesiology #dnpsrna #srnalife

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## Tags

nurses, nurseanesthesiology, crna, anesthetist, srnalife, nursingschool, nurseanesthesiologist, srna, anesthesia, anesthesiology, nursingstudent, nurseanesthetist, rntosrna, nurselife, crnajourney, futurecrna, anesthesiaschool, crnaschool, nursesofinstagram, dnpsrna, dnpcrna, srnatocrna, nurse, rn, ignurses

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