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Updated: Jun 19, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Extubation of pediatric patients: can nurses safely pull the tube?
1Evidence-Based Practice and Research Department, Children's Medical Center Dallas, Dallas, TX 75235, USA. rodica.pop@childrens.com
Abstract:
The purpose of this study was to evaluate the safety of pediatric extubation performed by nurses in the PACU after the implementation of an extubation policy. A total of 673 patients were extubated over 12 months. Five-hundred twenty-four (77.9%) of these patients met the criteria for nurse extubation; however, only 304 (58%) were extubated by nurses. One-hundred seventy-nine (34%) patients were not extubated by nurses because of a lack of physician order; a physician was present for 49 (9.3%) patients, and four (0.8%) patients had complications, resulting in a physician extubation. Only 8 (3%) patients extubated by nurses developed complications. These results suggest that nurses can safely perform endotracheal extubation of the pediatric population.
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