Unplanned Extubation: A Common and Costly Complication of Airway Management


  • Lauren Berkow University of Florida
  • Arthur Kanowitz Airway Safety Movement




extubation, complications, airway management


Endotracheal intubation and extubation are procedures routinely performed by clinicians who manage the airway of critically ill or injured patients (e.g., emergency physicians, anesthesiologists, and intensive care physicians) and patients undergoing general anesthesia (i.e., anesthesiologists and other anesthesia providers). Most of the time, extubation is a planned, intentional, and controlled event and in these circumstances the rate of complications related to extubation has been reported in the literature to be as high as 12%. The unplanned, unintentional, and uncontrolled removal of the endotracheal tube (ETT) can be either due to actions of the patient removing their own tube, defined as self-extubation, or due to an external force applied to the ETT during nursing care or movement of the patient that causes the dislodgement of the tube, defined as accidental extubation. Unplanned extubation is associated with significant complications, including aspiration pneumonia, hypoxemia, arrhythmias, vocal cord injury, brain damage, and death.

Author Biographies

Lauren Berkow, University of Florida

Lauren Berkow (lberkow@anest.ufl.edu) is a profes-sor for the Division of Neuroanesthesia and director of Anesthesia Supplies and Equipment, Department of Anesthesiology, at University of Florida College of Medicine. She is also president of the Society for Airway Management and on the Board of Directors of the Airway Safety Movement.

Arthur Kanowitz, Airway Safety Movement

Arthur Kanowitz is the founder and chairman of Securisyn Medical, founder of the Airway Safety Movement, co-chair of the Society for Airway Management Unplanned Extubation Awareness and Prevention Campaign, and co-chair of the Patient Safety Movement Foundation Airway Safety Workgroup: The Campaign to Zero Preventable Deaths.


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Endotracheal intubation machine next to patient in bed.



How to Cite

Berkow, L., & Kanowitz, A. (2020). Unplanned Extubation: A Common and Costly Complication of Airway Management. Patient Safety, 2(1), 22–30. https://doi.org/10.33940/med/2020.3.2



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