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Teachable Moment
Less Is More
September 2015

Prompt Extubation After Intensive Care Unit Procedures: A Teachable Moment

Author Affiliations
  • 1Boston University Internal Medicine Residency, Boston, Massachusetts
  • 2Veterans Affairs Boston Healthcare System, Boston, Massachusetts
  • 3Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2015;175(9):1447-1448. doi:10.1001/jamainternmed.2015.3656

An 80-year-old man presented with acute non–ST-segment elevation myocardial infarction requiring cardiac catheterization. His medical history included coronary artery disease with resultant ischemic cardiomyopathy, peripheral vascular disease, and hypothyroidism.

Prior to cardiac catheterization, the patient became agitated and confused and was unable to remain still, so the decision was made to intubate and sedate him for the procedure. After catheterization with placement of multiple stents, the patient remained intubated and sedated on propofol and was transferred to the cardiac care unit. Given his agitation, instructions from the attending cardiologist to the covering resident were to keep the patient intubated overnight to allow him to rest.

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