ABSTRACT
After IPPV, it is particularly important to be sure that resumed spontaneous ventilation is adequate before extubation; reintubation may not be easy. In addition to relying on physical signs (see Chapter 4), it is wise to test the adequacy of reversal of neuromuscular blocking agent by nerve stimulation (see Chapter 4), before awakening, which should show a well-sustained tetanus and minimally decrementing train of four. Control of the airway before the patient is fully awake should never be left to an inexperienced person.
