To the Editor

I have heard the question discussed “Who should extubate?” since the early 1970’s.

Extubation of patients in PACU should be done by the RN who is following specific established criteria approved by the Director of the Department of Anesthesia. On arrival of the patient to PACU, an anesthesiologist or CRNA should discuss with the PACU nurse any specific instructions for extubation and any intubation problem. Anesthesia should extubate patients who may have severe respiratory limitations.

The PACU nurse is expected to use professional judgment and communicate with the anesthesia person regarding any patient problems that may be encountered after they have left the room. The PACU nurse is expected to be a specialist in post anesthesia care. Not many hospitals are large enough to have an anesthesia floater available in PACU. Anesthesiologists, CRNA and PACU nurse must work cooperatively with one another and be supportive of one another.

The RN’s in PACU at our hospital have been extubating patients since the early 1970’s.

Utha May Morris, RN CCRN Arnarillo, TX