EMERGENCY PROCEDURES

-DEFIBRILLATION IN CPR
-ENDOTRACHEAL INTUBATION
-MECHANICAL VENTILATION
-CRICOTHYROTOMY
-ARTERIAL BLOOD GAS
-CENTRAL LINE PLACEMENT
-PERICARDIOCENTESIS
-URINARY BLADDER CATHETERIZATION
 DEFIBRILLATION IN CPR
(Cardiopulmonary Resuscitation)

• Defibrillation - is the treatment for

immediately life-threatening
arrhythmias with which the patient
does not have a pulse, is ventricular
fibrillation (VF) or pulse less
ventricular tachycardia (VT).
 How is defibrillation performed?
• The provider will start CPR until a heart defibrillator is available.
• The provider will apply two sticky defibrillator electrodes or paddles lubricated
with special jelly to your upper right chest and lower left ribcage area.
• The provider will analyze your heart rhythm and deliver a shock to your heart if
needed.
• The provider will re-analyze the resulting heart rhythm and provide more
shocks as needed.
 ENDOTRACHEAL (ET) INTUBATION

Endotracheal intubation is a
medical procedure in which a tube
is placed into the windpipe
(trachea) through the mouth or
nose. In most emergency situations,
it is placed through the mouth.
 Description
• Whether you are awake (conscious) or not awake (unconscious), you will be
given medicine to make it easier and more comfortable to insert the tube.
• The provider will insert a device called a laryngoscope to be able to view the
vocal cords and the upper part of the windpipe.
• A tube is then inserted into the windpipe and past the vocal cords to just
above the spot where the trachea branches into the lungs.
 ?

What are the risks

of intubation ?
 MECHANICAL VENTILATION

Mechanical ventilation is a
treatment to help a person breathe
when they find it difficult or are
unable to breathe on their own. A
mechanical ventilator pushes airflow
into the patient’s lungs to help them
breathe.
 Why is a mechanical ventilator used?

• As short-term respiratory assistance in surgeries

• For longer periods in critically ill patients
• At home by people who have difficulty breathing normally
• Does mechanical
ventilation treat
COVID-19 ?
 CRICOTHYROTOMY

Cricothyrotomy (also called

cricothyroidotomy) is a procedure that
involves placing a tube through an
incision in the cricothyroid membrane
(CTM) to establish an airway for
oxygenation and ventilation.
 Indications
-Inability to intubate.
-Inability to ventilate.
-Severe traumatic injury that
prevents oral or nasal tracheal
intubation.
Contraindications
-Inability to identify landmarks (cricothyroid
membrane).
-Underlying anatomical abnormality such as a tumor or
severe goiter.
-Tracheal transection.
-Acute laryngeal disease due to infection or trauma.
 ARTERIAL BLOOD GAS

• An ABG is a blood test

commonly performed in the
ICU and ER setting;
however, ABGs can be
drawn on any patient on any
floor depending on their
diagnosis.
 ABG Test Overview
-Partial pressure of oxygen -pH.
(PaO2). -Oxygen content (O2CT) and
oxygen saturation (O2Sat) values.
-Partial pressure of carbon
dioxide (PaCO2). -Bicarbonate (HCO3).
 What are the
meanings of ABG
test results?
 CENTRAL LINE PLACEMENT

A central line is a tiny tube that is placed

in a vein for long-term drug therapy or
kidney dialysis.

Why is it necessary?
A central line is necessary when you need
drugs given through your veins over a
long period of time, or when you need
kidney dialysis.
 How is it done?
The radiologist will place a small tube in the vein under your shoulder bone and anchor it by
making a small tunnel under your skin.
Before the procedure During the procedure
-You must not to eat or drink anything. -You will lie on an x-ray table with
-You need to bring a list of all your machines.
medications. -The nurse will give you pain medication
-A nurse will place an IV in your hand or and a sedative.
arm. -The radiologist will insert a needle into the
-……………….vv skin, creating a small tunnel.
-…………………vv
 PERICARDIOCENTESIS

• Pericardiocentesis is a procedure done

to remove fluid that has built up in the
sac around the heart (pericardium).

Process: there are two locations that

pericardiocentesis can be performed without
puncturing the lungs: the most standard location is
through the infrasternal angle and is also called
subxiphoid approach and another location is
through the 5th or 6th intercostal space at the left
sternal border at the cardiac notch of the left lung.
 Indications Contraindications

-Cardiac tamponade -Long-term drainage

-Analysis of pericardial fluid -Aortic dissection

-Pericarditis -Diagnosis of pericardial effusion

 URINARY BLADDER CATHETERIZATION

• In urinary catheterization a latex, or silicone

tube known as a urinary catheter is inserted
into the bladder through the urethra.
Catheterization allows urine to drain from the
bladder for collection. It may also be used to
inject liquids used for treatment or diagnosis of
bladder conditions.

Indications: urinary catheterization include acute

or chronic urinary retention, benign prostatic
hyperplasia, incontinence…vv
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