Physicians, physician associates (PAs), and nurse practitioners (NPs) need to be adept in a range of essential medical emergency procedures that they must perform in an inpatient settings. These bedside procedures are accomplished readily, but only if you have the proper knowledge and skills to do them correctly.
If you’re a working or aspiring medical professional who wants to master these basic procedures, we have listed all the procedures along with courses you can check out to boost your learning.
Let’s dive in.
What are the Common Procedures in Emergency Department?
If you’re a medical practitioner, PA, or NP, your diagnostic and clinical tool kit must include the following emergency procedures:
Procedural Sedation
This is a medical procedural technique that uses sedatives or analgesic medications to help relax a patient or create a controlled state of depressed consciousness before a medical procedure. Medical professionals usually administer the drugs through an IV line in the patient’s arm.
Central Line Placement
Physicians and advanced practice providers perform this procedure at the bedside ideally using ultrasound guidance in the ER, ICU or hospital wards. They do it by placing a small catheter in the vein in the femoral vein, subclavian vein or internal jugular vein and then suture it in place to anchor it.
Intraosseous Line Placement
Also known as intraosseous vascular access, this process involves placing a special hollow-bore needle through a bone cortex and into the medullary cavity. It is done for infusing medical therapeutic agents and lab testing.
Ultrasound-guided Peripheral IV (PIV) Placement
This procedure involves using ultrasound as guidance while placing a catheter in a patient’s peripheral veins in the upper extremities.
Ultrasound-guided Arterial Line Placement
In this procedure, a medical professional uses ultrasound, and a special arterial line kit or an angiocath to insert a catheter in the patient’s radial artery, brachial artery or femoral artery. This helps them monitor the patient’s blood pressure and take blood samples. An arterial line is commonly used in operating rooms and intensive care units (ICUs).
Ultrasound-guided Thoracentesis
Medical professionals do this procedure to remove fluid from the pleural cavity, which is the space between the chest wall and lungs. The procedure uses a needle and ultrasound guidance.
Ultrasound-guided Paracentesis
In this procedure, a medical professional removes ascites or excess peritoneal fluid from the belly using a thin, long needle or a specialized catheter.
Point-of-care Ultrasound Exam
This procedure uses ultrasound to diagnose problems and to help manage patients and provide answers to medical queries. It guides a clinical procedure and speeds up the diagnosis so the patient can receive more effective treatment. Point-of-care ultrasound (POCUS) is especially useful to determine the cause of hypotension (RUSH exam), in trauma to diagnose a pneumothorax, pericardial effusion or free fluid in the abdomen (E-FAST exam) or a pneumothorax (pleura ultrasound).
Mechanical Ventilation
There are many modes of mechanical ventilation but the most common initial mode is Assist Control ventilation. Mechanical ventilation involves using a ventilator to provide artificial ventilation fully or partially to a patient.
Needle Thoracostomy
These emergency procedures in hospitals are also known as needle decompression. It is done to decompress a tension pneumothorax by inserting a needle into the pleural cavity either in the mid-clavicular second intercostal space or the fourth intercostal mid-axillary space.
Tube Thoracostomy
This is a procedure in which a chest tube is inserted into the pleural space to drain air, blood, pus, bile, or other fluids.
Lumbar Puncture
A lumbar puncture or spinal tap is a test that healthcare providers uses to diagnose specific medical issues. They insert a needle into the space beneath the dura and between two vertebrae in the lower back to take out a cerebrospinal fluid sample for testing.
Endotracheal Intubation
This emergency medical procedure involves the placement of a tube into the trachea or windpipe through the mouth or nose. It is done on a patient who is unconscious or cannot breathe independently. It creates an artificial airway and allows healthcare providers to mechanically ventilate a patient.
Laryngeal Mask Airway (LMA) Placement
This procedure is commonly used during short procedures to substitute mask anesthesia in the operating room when endotracheal intubation is not needed. It is also used as a rescue airway for airway management.
King Tube Placement
This is one of the most common emergency room procedures that works as an alternative for endotracheal intubation and is used to provide advanced airway management.
What Procedures Should Someone Who is Working in a Medical Emergency Follow?
A medical professional in an emergency should follow the steps below:
- Review the situation calmly and look for signs and symptoms
- Assess the patient’s condition and response
- Diagnose and treat the patient as necessary
- Use data from various medical procedures to optimize clinical management
What Courses Should Someone Who Works or Wishes to Work in Emergency or Intensive Care Take?
A working or aspiring medical professional should take a course in emergency procedures that will help them perform procedures using the right skills and knowledge. Hospital Procedures Consultants offers physicians, NPs, and PAs, an online course in the subject, called the Hospitalist and Emergency Procedures CME course.
This Internet Continuing Medical Education (CME) curriculum includes the latest, evidence-based information about the 20 most common bedside procedures. Healthcare providers perform these procedures in the emergency room (ER), intensive care unit (ICU), and hospital wards.
The course comprises 19 modules that delve into the indications, contraindications, techniques, and complications of these procedures. It also covers fluid analysis and coding for them. It dives into the following procedures and topics:
- Informed consent
- Procedural sedation
- Intraosseous line placement
- Ultrasound-guided and landmark-guided central line placement
- Ultrasound-guided arterial line placement
- Ultrasound-guided peripheral IV placement
- Ultrasound-guided thoracentesis
- Ultrasound-guided paracentesis
- Point-of-care ultrasound including E-FAST and RUSH exams
- Mechanical ventilation
- Basic suturing
- Lumbar puncture
- Needle thoracostomy
- Tube thoracostomy including wire-directed pigtail catheter placement
- Endotracheal intubation
- Stylet-guided intubations
- Video laryngoscopy intubations
- King tube placement
- Laryngeal mask airway placement
- Performing procedures in patients suffering from thrombocytopenia, cirrhosis or who are on antiplatelets or anticoagulation
The course also offers hands-on procedural training, lecture PDFs, bonus lectures, and other unique benefits. The Postgraduate Institute jointly provides it for Medicine and Hospital Procedures Consultants to improve patient care and offer continuing education for medical professionals.
The following non-profit accreditation bodies jointly accredit the Postgraduate Institute for Medicine:
- Accreditation Council for Continuing Medical Education (ACCME)
- American Nurses Credentialing Center (ANCC)
- Accreditation Council for Pharmacy Education (ACPE)
So, you can be sure you’re in safe hands when you join this course.
Conclusion
Mastering basic emergency procedures help a medical professional respond to emergencies well and save lives. Taking a course in the subject can help you further build on your clinical knowledge and skills- and perform procedures in ERs and ICUs quickly and efficiently.
FAQS
What is the emergency room protocol?
There are some general steps and procedures commonly followed in emergency rooms:
- Triage
- Registration
- Medical Assessment
- Treatment
- Monitoring
- Consultation
- Discharge or Admission
- Follow-up
- Documentation
It’s important to note that emergency room protocols may be adapted or modified based on factors such as the hospital’s resources, the patient’s condition, and any specific protocols or guidelines in place for particular types of emergencies. Learn how to act in every circumstance with our courses.
What are the most common medical emergencies?
Some of the most common medical emergencies include:
- Heart Attack
- Stroke
- Severe Bleeding
- Respiratory Distress (e.g., asthma attack, difficulty breathing)
- Seizures
- Allergic Reactions (e.g., anaphylaxis)
- Traumatic Injuries (e.g., fractures, head injuries)
- Poisoning
- Sudden Cardiac Arrest
- Diabetic Emergencies (e.g., diabetic ketoacidosis, hypoglycemia)
It’s important to note that these are general categories, and within each category, there can be a wide range of specific medical conditions and situations that require immediate attention in an emergency room.
The common procedures in emergency department rely on different methods that are very important for taking care of patients suffering a critical condition (in an effective way). Airway management, central and peripheral line placement, sedation and more follow important guidelines to achieve a quick diagnosis. All of them not only help to stabilize a patient, but also to do it with accurate balance. Providing proper training can improve these methods and elevate the standards.
