AACN Procedure Manual for Critical Care
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1 AACN Procedure Manual for Critical Care Wiegand, Debra Lynn-McHale PhD, RN ISBN-13: Table of Contents UNIT I Pulmonary System Section One Airway Management: Michael W. Day 1. Combitube Insertion and Removal AP 2. Endotracheal Intubation (Perform) AP 3. Endotracheal Intubation (Assist) 4. Endotracheal Tube and Oral Care 5. Extubation/Decannulation (Perform) AP 6. Extubation/Decannulation (Assist) 7. Laryngeal Mask Airway AP 8. Emergency Cricothyroidotomy (Perform) NEW! 9. Emergency Cricothyroidotomy (Assist) NEW! 10. Nasopharyngeal Airway Insertion 11. Oropharyngeal Airway Insertion 12. Suctioning: Endotracheal or Tracheostomy Tube 13. Tracheal Tube Cuff Care 14. Tracheostomy Tube Care Section Two Special Pulmonary Procedures: Michael W. Day 15. Continuous End-Tidal Carbon Dioxide Monitoring 16. Continuous Venous Oxygen Saturation Monitoring 17. Oxygen Saturation Monitoring by Pulse Oximetry 18. Pronation Therapy Section Three Thoracic Cavity Management: Michael W. Day 19. Autotransfusion 20. Chest Tube Placement (Perform) AP 21. Chest Tube Placement (Assist) 22. Chest Tube Removal (Perform) AP 23. Chest Tube Removal (Assist) 24. Closed Chest Drainage System 25. Needle Thoracostomy (Perform) AP 26. Thoracentesis (Perform) AP
2 27. Thoracentesis (Assist) Section Four Ventilatory Management: Michael W. Day 28. Noninvasive Ventilation (CPAP and BiPAP Masks) NEW! 29. Arterial-Venous Oxygen Content Difference (a-v DO2) and Oxygen Transport (Delivery) and Consumption Calculations 30. Auto-PEEP Calculation 31. Compliance and Resistance Measurement 32. Manual Self-Inflating Resuscitation Bag 33. Indices of Oxygenation 34. Shunt Calculation 35. Invasive Mechanical Ventilation (Through an Artificial Airway)---Volume and Pressure Modes36. Standard Weaning Criteriaâ Negative Inspiratory Pressure, Positive End-Expiratory Pressure, Spontaneous Tidal Volume, Vital Capacity, and Rapid Shallow Breathing Index 37. Weaning Process 38. Peripheral Nerve Stimulators UNIT II Cardiovascular System Section Five Cardiac Emergencies: Debra Wiegand 39. Automated External Defibrillation 40. Cardioversion 41. Defibrillation (External) 42. Defibrillation (Internal) AP 43. Emergent Open Sternotomy (Perform) AP 44. Emergent Open Sternotomy (Assist) 45. Pericardiocentesis (Perform) AP 46. Pericardiocentesis (Assist) Section Six Cardiac Pacemakers: Debra Wiegand 47. Atrial Electrogram 48. Atrial Overdrive Pacing (Perform) AP 49. Epicardial Pacing Wire Removal AP 50. Implantable Cardioverter-Defibrillator 51. Permanent Pacemaker (Assessing Function) 52. Temporary Transcutanous (External) Pacing 53. Temporary Transvenous Pacemaker Insertion (Perform) AP 54. Temporary Transvenous and Epicardial Pacing Section Seven Circulatory Assist Devices: Debra Wiegand 55. Intraaortic Balloon Pump Management
3 56. Ventricular Assist Devices Section Eight Electrocardiographic Leads and Cardiac Monitoring: Debra Wiegand 57. Electrophysiologic Leads and Cardiac Monitoring 58. Extra Electrocardiographic Leads: Right Precordial and Left Posterior Leads 59. Continuous ST-Segment Monitoring 60. Twelve-Lead Electrocardiogram Section Nine Hemodynamic Monitoring: Debra Wiegand 61. Arterial Catheter Insertion (Perform) AP 62. Arterial Catheter Insertion (Assist), Care and Removal 63, Arterial Pressure-Based Cardiac Output Monitoring 6. Blood Sampling From an Arterial Catheter 65, Blood Sampling from a Central Venous Catheter 66. Blood Sampling From a Pulmonary Artery Catheter 67. Cardiac Output Measurement Techniques (Invasive) 68. Central Venous Catheter Removal 69. Central Venous Catheter Site Care 70. Central Venous/Right Atrial Pressure Monitoring 71. Left Atrial Catheter: Care and Assisting With Removal 72. Pulmonary Artery Catheter Insertion (Perform) AP 73. Pulmonary Artery Catheter Insertion (Assist) and Pressure Monitoring 74. Pulmonary Artery Catheter Removal 75. Pulmonary Artery Catheter and Pressure Lines, Troubleshooting 76. Single- and Multiple-Pressure Transducer Systems Section Ten Special Cardiac Procedures: Debra Wiegand 77. Arterial and Venous Sheath Removal AP 78. Pericardial Catheter Management 79. Transesophageal Echocardiography (Assist) Section Eleven Vascular Access: Debra Wiegand 80. Arterial Puncture AP 81. Central Venous Catheter Insertion (Perform) AP 82. Central Venous Catheter Insertion (Assist) 83. Implantable Venous Access Device: Access, Deaccess, and Care AP 84. Intraosseous Devices 85. Peripherally Inserted Central Catheter AP UNIT III Neurologic System
4 Section Twelve Neurologic Monitoring: Patricia A. Blissitt 86. Bispectral Index Monitoring 87. Brain Tissue Oxygenation Monitoring: Insertion (Assist), Care, and Troubleshooting 88. Intracranial Bolt and Fiberoptic Catheter Insertion (Assist), Intracranial Pressure Monitoring, Care, Troubleshooting, and Removal 89. Combination Intraventricular/Fiberoptic Catheter Insertion (Assist) and Monitoring 90. Jugular Venous Oxygen Saturation Monitoring: Insertion (Assist), Care, Troubleshooting, and Removal 91. Lumbar Subarachnoid Catheter Insertion (Assist) for Cerebral Spinal Fluid Pressure Monitoring and Drainage 92. Intraventricular Catheter with External Transducer for Cerebrospinal Fluid Drainage and Intracranial Pressure Monitoring93. Transcranial Doppler Monitoring AP Section Thirteen Special Neurologic Procedures: Pat Blissitt 94. External and Intravascular Warming/Cooling Devices 95. Lumbar Puncture (Perform) AP 96 Lumbar Puncture (Assist) Section Fourteen Traction Management: Patricia A. Blissitt 97. Application of Tongs or Halo Ring for Use in Cervical Traction 98. Halo Ring and Vest Care 99. Pin Site Care: Cervical Tongs and Halo Pins 100. Cervical Traction Maintenance Section Fifteen Pain Management: Patricia A. Blissitt 101. Epidural Catheters: Assisting with Insertion and Pain Management 102. Patient-Controlled Analgesia 103. Peripheral Nerve Blocks: Assisting with Insertion and Pain Management UNIT IV Gastrointestinal System Section Sixteen Special Gastrointestinal Procedures: Eleanor Fitzpatrick 104. Esophagogastric Tamponade Tube 105. Gastric Lavage in Hemorrhage and Overdose 106. Intraabdominal Pressure Monitoring 107. Paracentesis (Perform) AP 108. Paracentesis (Assist) 109. Peritoneal Lavage (Perform) AP 110. Peritoneal Lavage (Assist) 111. Endoscopic Therapy UNIT V Renal System Section Seventeen
5 Renal Replacement: Teresa Preuss 112. Continuous Renal Replacement Therapies 113. Hemodialysis 114. Peritoneal Dialysis UNIT VI Hematologic System Section Eighteen Fluid Management: Teresa Preuss 115. Use of a Massive Transfusion Device and a Pressure Infusor BagSection NineteenSpecial Hematologic Procedures: Teresa Preuss 116. Apheresis and Therapeutic Plasma Exchange (Assist) 117. Bone Marrow Biopsy and Aspiration (Perform) AP 118. Bone Marrow Biopsy and Aspiration (Assist) UNIT VII Integumentary System Section TwentyBurn Wound Management: Mary Beth Makic 119. Donor Site Care 120. Burn Wound Care 121. Skin Graft Care Section Twenty-One Special Integumentary Procedures: Mary Beth Makic 122. Intracompartmental Pressure Monitoring AP 123. Pressure Redistribution Surfaces: Continual Lateral Rotation Therapy and Rotorest Lateral Rotation Surface 124. Wound Closure AP 125. Suture and Staple Removal Section Twenty-Two Wound Management: Mary Beth Makic 126. Cleaning, Irrigating, Culturing, and Dressing an Open Wound 127. DÃ bridement: Pressure Ulcers, Burns, and Wounds AP 128. Wound Management with Excessive Drainage 129. Drain Removal 130. Fecal Containment Devices and Bowel Management System NEW! 131. Negative-Pressure WoundTherapy UNIT VIII Nutrition: Eleanor Fitzpatrick 132. Small-Bore Feeding Tube Insertion Using an Electromagnetic Guidance System (CORTRAKÂ ) NEW! 133. Percutaneous Endoscopic Gastrostomy (PEG), Gastrostomy, or Jejunostomy Tube Care 134. Small-Bore Feeding Tube Insertion and Care UNIT IX End of Life: Debra Wiegand 135. Determination of Death in Adult Patients AP 136. Organ Donation: Identification of Potential Organ Donors, Request for Organ Donation, and Care of the Organ Donor 137. Cardiac Donation
6 138. Withholding and Withdrawing Life-Sustaining Therapy UNIT X Calculating Medication Doses: Eleanor Fitzpatrick 139. Calculating Doses, Flow Rates, and Administration of Continuous Intravenous Infusions
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