Terminal Extubation: The Role of EMS
Recognizing a patient who needs ventilatory support, correctly placing an endotracheal tube, and transporting the patient to the hospital is classic prehospital care. In this article, we present a case of exactly the opposite: transporting a patient home and removing an endotracheal tube to allow them to die. EMS providers and an EMS physician worked to ensure a patient’s last wishes were upheld. This is an unusual but important opportunity for EMS to impact a patient and a family.
- Articulate the benefits of allowing eligible patients to die at home
- Identify the other caregivers and providers who should be included in the decision-making, transport, and extubation processes
- Describe the transport process and contingency plans if something goes wrong
- Understand what interventions are allowed and available after extubation
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