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Practical Procedures in Critical Care

During your rotation in critical care you will be involved and trained in practical procedures. You must not undertake any practical procedure unless you are competent to do so. Ensure that the first time you undertake a procedure you are supervised by a senior doctor or practitioner that are competent with the procedure.

The clean utility areas in each unit contain ready prepared boxes containing all the required equipment for a particular procedure (arterial line, central line, chest drain, lumbar puncture, nasogastric tube, tracheostomy).

After you have completed the procedure ensure all sharps and clinical waste are disposed of. Please return the used box to the dirty utility room and ask a healthcare assistant to restock. 

The use of ultrasound to assist central line placement is mandatory. We have several USS equipment for line placement.

Please ask to be shown how to use the equipment . There will be a teaching session in the first few weeks to help you. 

There are teaching videos and papers from the New England Journal of Medicine (see below) to provide you with a practical guide and background information about commonly performed procedures. There are also pathways for most of the procedures combined with a LocSSIP (Local Safety Standards for Invasive Procedures), which are mandated to use every time you perform a procedure. You should be supervised by a senior clinician at all times whilst learning.

Information and LoCSSIPs for some of the procedures

Videos in Clinical Medicine for invasive procedures (NEJM)

Arterial Line
 Insertion

Central Venous
Catheter Insertion

Femoral Vein
Catheter Insertion

Peripheral Vein Cannula 
  Insertion with USS

Chest Drain
   Insertion


Needle Aspiration
of Pneumothorax

Lumbar 
Puncture


Paracentesis





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