Emergency Care Procedures and Interventions
Concepts to master
Procedural competence includes airway management (bag-mask ventilation, supraglottic airways, intubation, surgical airway), vascular access, chest decompression and thoracostomy, defibrillation and cardioversion, splinting, wound management, and resuscitation team dynamics. Understand indications, contraindications, and confirmation of placement. Know that waveform capnography is the standard for confirming and continuously monitoring endotracheal tube placement.
Safety and technique
Understand universal precautions, sterile technique for invasive procedures, and the concept of a failed airway algorithm. Recognize that procedural sedation requires monitoring, and that informed consent may be waived in true emergencies but must be documented.
Traps to watch
- Confirming tube placement by auscultation alone rather than capnography.
- Choosing a surgical airway before optimizing bag-mask ventilation and basic airway positioning.
- Failing to reassess after a procedure; every intervention requires a post-procedure check.
- Ignoring contraindications such as needle decompression site selection errors or thoracostomy in a patient with coagulopathy when alternatives exist.
Rule of thumb
Every procedure has three phases: indication, execution, and confirmation. Exam questions often test the confirmation step. For airway, remember: position, suction, bag-mask, then advanced airway.
Worked example: After intubation, the provider auscultates equal breath sounds but the capnography waveform is absent. The correct interpretation is esophageal placement, and the tube should be removed and oxygenation reestablished.