extubation after breast surgery

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extubation after breast surgery

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Hello i'm the waking up from coma anon and I read all you coma tag but there are still couple questions if you don't mind ^^
From patient perspective, i read that the doctor will wait for the patient to be conscious enough before extubation because they need to follow instruction. What kind of instruction do doctor usually ask the patien to do before and during the process and is the process painful/uncomfy?
From caretake perspective, i read that waking up from coma is a gradual process that can take days, i assume that mean the patient is drifting on and off conscious. What should the caretaker do when the patient is slowly waking up but not aware yet asumming it happened several times, and how conscious the patient for the caretaker to "Oh yeah i think i need to call the nurse now?"
A patient needs to be able to follow commands prior to intubation to ensure that they can take deep breaths and cough when asked to.
Regaining consciousness from a coma is very gradual, but "going in and out of consciousness" may not be noticeable. The patient may have fleeting moments of awareness, but these may not be distinguishable to an outside observer. Motor function, voluntary or involuntary, would likely be more noticeable.
The caretaker wouldn't necessarily need to call the nurse unless the patient's vitals suddenly changed (a rise or drop in blood pressure or oxygen saturation).
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9-1-1 Lone Star: 3x04 “Push”
28. "I should've stayed home"
Part 1 | Part 2
Tom looked up at her, catching the urgency in her tone. He reached to rub at Finn’s chest, knuckles on bare skin. "Finn, come on, take a breath. You can do it."
"He's not going to, is he?" She murmured.Â
"I've got the BVM. Do you want to update them and get the pads on?" Tom asked, swapping the masks over. "There we go, that's getting air entry there. Sats are coming back up. Should we intubate?"
Fao bit his lip, feeling his stomach twist. This wasn’t uncommon for Finn, but it wasn’t good. It was the end of their holiday, that was for certain, and they were desperately far away from their safety net. They had all his paperwork with them, management plans and everything, but it was still worrying.Â
He forced himself to take a deep breath, wishing Finn could do the same.Â
Finn ended up intubated, crit care travelling with them to keep him sedated and stable. While Sheila travelled with them, Fred and Fao had to follow in the car behind them. With the severity of the situation, they pre-alerted him in, travelling on blues and treating with diesel. It was straight through to resus when they arrived, teams swarming around Finn. As awful as it sounded, Sheila was glad Finn was sedated, he'd have been unable to cope with the fuss and everything on top of him. He was quickly sent for scans, thankfully stable enough to go to CT, but Sheila couldn't help the worry and nausea that curled in her stomach. They were meant to be on holiday. Finn had been doing so well, and now they were in resus, and he was very much not okay.Â

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Coughing Up a Lung. The Fall.
Season 3, Episode 2
Hi, I’m writing a fic and I can’t find anywhere how doctors take a ventilator tube out of a patient. I know most of the other things about it, and how it goes in but I can find how to take it out and if the patient is awake for this or not. Thank you!
Here is a great video that demonstrates the removal of an endotracheal “ET” tube- the tube that pushes air into the patient’s lungs from a ventilator. The patient is usually awake for the removal of the tube. The tube is held in place by a small balloon, which is deflated with a syringe. After it’s deflated, the tube can be pulled out:
Quiet Down (Part One)
Finn hadn’t been conscious for the first week back in England. Hadn’t been given the chance to try.Â
As soon as they’d been allowed, the Daniels had set up a vigil by his bedside, Jess joining them as much as she could with Amelia. Sure, he was stable, but he wasn’t trying to do anything himself. Wasn’t showing any real signs of life, save for the occasional panicked glance around the room.Â
Fred had been sitting with him when he finally tries, Finn panicking and starting to fight the tube. It’s unwelcome and he can’t breathe past it as he attempts to reach and pull it out himself. His arms aren’t under his control anymore, and they don’t move. Aware that someone is trying to talk to him, that someone has their hand on his shoulder, he forces his eyes open.
Dad.
Finn begs him to take it out, to help him instead of standing there, but he doesn’t do anything. He doesn’t seem panicked, either, and it takes a second for Finn to realise that he isn’t dying. Not this time.
Nurses finally arrive, quickly paging the anaesthetist and attempting to calm Finn down. He doesn’t listen to them, searching for his dad with his hand outstretched. Relief floods through him as his dad grabs it, squeezing it tight, and he shuts his eyes again. He could do this. He just needed to breathe.
Finn watches them a little longer, trying to push the fear down and pretend that things were fine. He wasn’t sure of where he was or what was actually going on, but his dad wouldn’t hurt him, and he had to trust he wouldn’t let anyone else.
 With another gag, Finn makes his mind up. He reaches for the plastic in his mouth and pulls before anyone can stop him.Â
His throat burns and he retches again, but he still can’t breathe. He fights the nurses as they hold him down, trying to put something on his face. He doesn’t want it, doesn’t want any of it. He just wants to be home.
He doesn’t notice he’s crying until he feels his dad’s hand on his cheek, hears him telling him that he’s okay, he’s safe now. Finally settling, the nurses manage to get him on nasal oxygen, soothing him back into the bed. His throat still burns and he’s dizzy as anything, but he’s breathing, and it’s all him.