Skip to main content

You must be logged in to purchase this course.

Existing users login here | New users register here

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


Clemency BM, Grimm KT, Lauer SL, et al. Transport home and terminal extubation by emergency medical services. J Pain Symptom Manage, 2019 Mar 21, epub ahead of print. 

Ghabeljoo J. End of Life Care Practices for Patients Who Die in Intensive Care Units (ICU). SJSU ScholarWorks, 

Emanuel EJ, Onwuteaka-Philipsen BD, Urwin JW, Cohen J. Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe. JAMA, 2016 Jul 5; 316(1): 79–90. 

Masman AD, van Dijk M, Tibboel D, Baar FP, Mathot RA. Medication use during end-of-life care in a palliative care centre. Int J Clin Pharm, 2015 Oct; 37(5): 767–75.  

  • Format
  • Duration
    0.5 hours
  • Credits
    0.5 CE
  • After passing the course, your certificate will be available for download here.