ICU Procedures

A physiologically safe ICU intubation workflow from preparation and preoxygenation through laryngoscopy, tube confirmation and post-intubation stabilization.

Emergency front-of-neck airway for a cannot-intubate/cannot-oxygenate situation when noninvasive rescue cannot maintain oxygenation.

ICU percutaneous tracheostomy planning, equipment, bronchoscopic/ultrasound support, dilatation sequence and immediate complication management.

Planned tracheostomy tube exchange with maturity-of-tract assessment, oxygenation strategy and immediate rescue plan.

Central venous access using real-time ultrasound, maximal sterile barrier precautions, wire safety and reliable confirmation before high-risk use.

Ultrasound-assisted arterial cannulation for continuous blood pressure monitoring and blood sampling with emphasis on distal perfusion and waveform quality.

Placement of a large-bore non-tunneled dialysis catheter with site selection, ultrasound guidance, sterile technique and flow troubleshooting.

Advanced hemodynamic catheter placement using sequential pressure waveforms, with explicit attention to arrhythmia, knotting and pulmonary artery injury risk.

Ultrasound-guided peripheral access for difficult IV access with emphasis on catheter length, vein depth and continuous needle-tip visualization.

Peripheral midline access for intermediate-duration compatible infusions, distinguished clearly from central venous access.

PICC selection and placement overview focused on appropriateness, ultrasound access, central tip confirmation and thrombosis/infection risk.

Diagnostic or therapeutic pleural aspiration using mandatory ultrasound localization for fluid, controlled drainage and complication surveillance.

Image-guided Seldinger or open drain placement with safe-zone anatomy, drainage-system setup, securement and troubleshooting.

Structured pleural-drain removal after confirming that the original indication has resolved and the patient can tolerate removal.

ICU bronchoscopy workflow for secretion clearance, airway inspection and BAL sampling with oxygenation/ventilation safeguards.

Team-based prone-positioning procedure with airway/line security, pressure-point protection and a structured emergency-turn-back plan.

Echo-guided drainage of hemodynamically significant pericardial effusion with route selection based on the safest fluid window rather than a fixed landmark approach.

Temporary endocardial pacing for unstable bradyarrhythmia when pharmacologic/transcutaneous measures are insufficient or a bridge is required.

Urgent synchronized shock delivery for unstable tachyarrhythmia with attention to synchronization, sedation when feasible and immediate rhythm reassessment.

Immediate bridge pacing for unstable symptomatic bradycardia when atropine is ineffective or inappropriate, while preparing definitive therapy.

Critical-care TEE preparation and probe-safety overview for credentialed echocardiography operators.

High-level VV/VA ECMO cannulation planning, imaging confirmation and immediate complication recognition for ICU teams supporting an ECLS service.

Specialist VV/VA ECMO liberation overview that separates respiratory off-sweep testing from VA low-flow/trial-off assessment and emphasizes circuit-thrombosis, bleeding and vascular safety.

Specialist overview of femoral IABP insertion, radiographic positioning, timing and immediate vascular complications.

ICU support guide for transvalvular microaxial-flow pumps: position confirmation, preload dependence, suction alarms, hemolysis and anticoagulation.

Ultrasound-assisted peritoneal fluid sampling or large-volume drainage with specimen handling, albumin planning and bleeding/leak surveillance.

CSF acquisition with pre-procedure neurologic safety screening, sterile positioning, opening pressure when indicated and correct specimen sequencing.

Enteral tube placement with explicit confirmation before feeding or medication administration.

Standardized transvesical intra-abdominal pressure measurement for suspected intra-abdominal hypertension/abdominal compartment syndrome.

Bedside EVD management fundamentals: reference leveling, prescribed drainage height, waveform/ICP checks and infection-safe handling.

ICU overview of image-guided gallbladder drainage for selected high-risk acute cholecystitis patients who are not immediate operative candidates.

ICU overview of urgent upper-tract decompression for infected obstructed collecting systems and selected urinary obstruction.

Immediate decompression when tension pneumothorax is causing shock or peri-arrest physiology, followed by definitive pleural drainage.

Rapid emergency vascular access when IV access is delayed or impossible, with site selection, securement and early transition to definitive access.

Unsynchronized shock workflow integrated with high-quality CPR for ventricular fibrillation or pulseless ventricular tachycardia.

Emergency sequence for a deteriorating tracheostomy patient: call for help, oxygenate both potential airways, remove obstruction and re-establish a safe airway.

Emergency release of constricting circumferential full-thickness burn eschar when limb perfusion or chest-wall ventilation is compromised.