The inadvertent removal of an endotracheal tube (ET) by patients who are either not responsible for or not aware of their actions. To prevent a recurrence, the health care provider must be skilled in securing the ET. The tube needs to be firmly secured, tube-related discomfort minimized, and the patient’s delirium and agitation controlled. This may require careful patient monitoring, or occasionally, sedation, paralysis, or the application of physical restraints. Immediate reintubation may be indicated in a patient who is unable to oxygenate or ventilate on his own.