End of case

Emergence, extubation & PACU handoff

The most dangerous minutes of a routine anesthetic are often the last ones. Know what the team is checking.

Extubation readiness

Awake and following commands (or a deliberate deep extubation chosen by the team)
Quantitative TOF ratio ≥ 0.9
Breathing adequately: tidal volume ≈ > 5 mL/kg, RR < 30, acceptable SpO₂ on low FiO₂ and acceptable ETCO₂
Hemodynamically stable, normothermic
Pain controlled, bleeding controlled
Oropharynx suctioned; airway swelling considered (cuff-leak if concerned)

Typical criteria — the team decides. Practice checklist only; resets on reload.

Patient	Name and age (the team states identifiers), allergies
Procedure	What was done; surgeon concerns
Anesthetic	Type; airway device and grade; lines
Meds	Opioids and timing, reversal and TOF ratio, antiemetics, antibiotics and redose time
Fluids	In; estimated blood loss; urine output
Events	Difficult airway, hypotension, anything unexpected
Now	Vitals, pain, nausea
Plan	What to watch (e.g., OSA desaturation, bleeding), labs, disposition
Questions	“What questions do you have?”

Then help the PACU nurse get the patient onto monitors — and stay until your resident hands over.