Table 5.

Protocol for preparation and procedure for weaning^39,40

Preparation: Inform the patient (if conscious), about The steps of Weaning process and what is expected of him or her. Regarding the procedure in detail (first to remove ventilator and then to remove Endotracheal Tube Probable difficulty in breathing through the tube Reassurance Use ventilator cards which helps intubated patients to communicate (like sign boards) Suctioning equipment, Oxygen therapy devices, oral and nasal airways and Intubation tray should be standby. (including equipment for difficult intubation) Procedure: Once preparation is done, keep patient in comfortable propped up position. Pre-oxygenation (increase FiO2 by 10–20% except in COPD patients) Do thorough endotracheal, nasogastric and oral suctioning. Plan the mode of weaning- low pressure support or T-piece Take patient off the ventilator if weaning is planned through T-piece OR switch over to low pressure support mode (Pressure Support 6–8 cm H2O above PEEP and PEEP 5 cm H2O)

Modified from references 39 and 40