This presentation discusses safe extubation of adult patients in the post-anesthesia care unit (PACU). Laryngospasm is the most common cause of post-extubation airway obstruction and can be life-threatening. Registered nurses should not extubate patients who are at high risk, such as those with difficult airway, residual neuromuscular block, or full stomach. Prior to extubation, patients must be awake, following commands, breathing spontaneously, and have adequate oxygen saturation. The 5 steps for safe extubation include suctioning the posterior pharynx, removing tape, deflating the endotracheal tube cuff, extubating at the end of inspiration, and steadily