AACN Procedure Manual for High Acuity, Progressive, and Critical Care

UNIT I: Pulmonary System

Section One: Airway Management 1. Combitube Insertion and Removal AP 2. Endotracheal Intubation (Perform) AP 3. Endotracheal Intubation (Assist) 4. Endotracheal Tube and Oral Care Practices for Ventilated and Non-ventilated Patients 5. Extubation/Decannulation (Perform) AP 6. Extubation/Decannulation (Assist) 7. NEW! King Airway Insertion and Removal AP 8. Laryngeal Mask Airway AP 9. Nasopharyngeal and Oral Airway Insertion 10. Suctioning: Endotracheal or Tracheostomy Tube 11. Surgical Cricothyrotomy (Perform) AP 12. Surgical Cricothyrotomy (Assist) 13. Tracheostomy Cuff and Tube Care

Section Two: Special Pulmonary Procedures 14. Continuous End-Tidal Carbon Dioxide Monitoring 15. Continuous Lateral Rotation Therapy 16. Continuous Venous Oxygen Saturation Monitoring 17. NEW! Extracorporeal Life Support (ECLS) and Extracorporeal Membrane Oxygenation (ECMO) 18. Oxygen Saturation Monitoring with Pulse Oximetry 19. Pronation Therapy

Section Three: Thoracic Cavity Management 20. Autotransfusion 21. Chest Tube Placement (Perform) AP 22. Chest Tube Placement (Assist) 23. Chest Tube Removal (Perform) AP 24. Chest Tube Removal (Assist) 25. Closed Chest Drainage System 26. Needle Thoracostomy (Perform) AP 27. Thoracentesis (Perform) AP 28. Thoracentesis (Assist)

Section Four: Ventilatory Management 29. Invasive Mechanical Ventilation (Through an Artificial Airway):  Volume and Pressure Modes 30. Noninvasive Positive Pressure Ventilation: Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP) 31. Manual Self-Inflating Resuscitation Bag-Valve Device 32. Peripheral Nerve Stimulators 33. Weaning Mechanical Ventilation

UNIT II: Cardiovascular System

Section Five: Cardiac Emergencies 34. Automated External Defibrillation 35. Cardioversion 36. Defibrillation (External) 37. Defibrillation (Internal) (Perform) AP 38. NEW! Defibrillation (Internal) Assist 39. Emergent Open Sternotomy (Perform) AP 40. Emergent Open Sternotomy (Assist) 41. NEW! External Wearable Cardioverter Defibrillator 42. Pericardiocentesis (Perform) AP 43. Pericardiocentesis (Assist)

Section Six: Cardiac Pacemakers 44. Atrial Electrogram 45. Atrial Overdrive Pacing (Perform) AP 46. Epicardial Pacing Wire Removal AP 47. Implantable Cardioverter-Defibrillator 48. Permanent Pacemaker (Assessing Function) 49. Temporary Transcutanous (External) Pacing 50. Temporary Transvenous Pacemaker Insertion (Perform) AP 51. Temporary Transvenous and Epicardial Pacing

Section Seven: Circulatory Assist Devices 52. Intraaortic Balloon Pump Management 53. Ventricular Assist Devices AP

Section Eight: Electrocardiographic Leads and Cardiac Monitoring 54. Cardiac Monitoring and Electrocardiographic Leads 55. Extra Electrocardiographic Leads: Right Precordial and Left Posterior Leads 56. ST-Segment Monitoring (Continuous) 57. Twelve-Lead Electrocardiogram

Section Nine: Hemodynamic Monitoring 58. Arterial Catheter Insertion (Perform) AP 59. Arterial Catheter Insertion (Assist), Care, and Removal 60. Arterial Pressure-Based Cardiac Output Monitoring 61. Blood Sampling from an Arterial Catheter 62. Blood Sampling from a Central Venous Catheter 63. Blood Sampling from a Pulmonary Artery Catheter 64. Cardiac Output Measurement Techniques (Invasive) 65. Central Venous Catheter Removal 66. Central Venous Catheter Site Care 67. Central Venous/Right Atrial Pressure Monitoring 68. NEW! Esophageal Cardiac Output Monitoring: Perform AP 69. NEW! Esophageal Cardiac Output Monitoring: Assist 70. NEW! Non-Invasive Cardiac Output Monitoring 71. Pulmonary Artery Catheter Insertion (Perform) AP 72. Pulmonary Artery Catheter Insertion (Assist) and Pressure Monitoring 73. Pulmonary Artery Catheter Removal 74. Pulmonary Artery Catheter and Pressure Lines, Troubleshooting 75. Single-Pressure and Multiple-Pressure Transducer Systems

Section Ten: Special Cardiac Procedures 76. Femoral Arterial and Venous Sheath Removal 77. NEW! Radial Arterial Sheath Removal 78. Pericardial Catheter Management 79. NEW! Thenar Tissue Oxygen Saturation Monitoring 80. Transesophageal Echocardiography (Assist)

Section Eleven: Vascular Access 81. Arterial Puncture AP 82. Central Venous Catheter Insertion (Perform) AP 83. Central Venous Catheter Insertion (Assist) 84. Implantable Venous Access Device: Access, Deaccess, and Care AP 85. Intraosseus Devices       86. NEW! Mid Line Catheters AP 87. Peripherally Inserted Central Catheter AP

UNIT III:  Neurologic System

Section Twelve: Neurologic Monitoring 88. Bispectral Index Monitoring 89. Brain Tissue Oxygenation Monitoring: Insertion (Assist), Care, and Troubleshooting 90. NEW! Cerebral Blood Flow Monitoring 91. NEW! Cerebral Micodialysis 92. NEW! Intracranial Bolt and Fiberoptic Catheter Insertion (Assist), Intracranial Pressure Monitoring, Care, Troubleshooting, and Removal 93. Intraventricular/Fiberoptic Catheter Insertion (Assist), Monitoring, Nursing Care, Troubleshooting, and Removal 94. Intraventricular Catheter with External Transducer for Cerebrospinal Fluid Drainage and Intracranial Pressure Monitoring 95. Lumbar Subarachnoid Catheter Insertion (Assist) for Cerebrospinal Fluid Drainage and Pressure Monitoring

Section Thirteen: Special Neurologic Procedures 96. Lumbar Puncture (Perform) AP 97. Lumbar Puncture (Assist) 98. NEW! Pupillometer 99. Rotorest® Lateral Rotation Surface 100. Thermoregulation: External and Intravascular Warming & Cooling Devices

Section Fourteen: Traction Management 101. Cervical Tongs or Halo Ring: Application for Use in Cervical Traction (Assist) 102. Cervical Traction Maintenance 103. Halo Ring and Vest Care 104. Pin Site Care: Cervical Tongs and Halo Pins

Section Fifteen: Pain Management 105. Epidural Catheters: Assisting with Insertion and Pain Management 106. Patient-Controlled Analgesia 107. Peripheral Nerve Blocks: Assisting with Insertion and Pain Management

UNIT IV: Gastrointestinal System

Section Sixteen: Special Gastrointestinal Procedures 108. Esophagogastric Tamponade Tube 109. NEW! Focused Assessment with Sonography in Trauma (FAST) 110. Gastric Lavage in Hemorrhage and Overdose 111. Endoscopic Therapy 112. Intraabdominal Pressure Monitoring 113. NEW! Nasogastric and Orogastric Tube Insertion, Care, and Removal 114. NEW! Molecular Adsorbents Recirculation System (MARS) 115. Paracentesis (Perform) AP 116. Paracentesis (Assist) 117. Peritoneal Lavage (Perform) AP 118. Peritoneal Lavage (Assist)

UNIT V: Renal System

Section Seventeen: Renal Replacement 119. Continuous Renal Replacement Therapies 120. Hemodialysis 121. Peritoneal Dialysis

UNIT VI: Hematologic System

Section Eighteen: Fluid Management 122. Use of a Massive Infusion Device and a Pressure Infuser Bag

Section Nineteen: Special Hematologic Procedures 123. Apheresis and Therapeutic Plasma Exchange (Assist) 124. Bone Marrow Biopsy and Aspiration (Perform) AP 125. Bone Marrow Biopsy and Aspiration (Assist)

UNIT VII: Integumentary System

Section Twenty: Burn Wound Management 126. Burn Wound Care 127. Donor Site Care 128. Skin Graft Care

Section Twenty-One: Special Integumentary Procedures 129. Intracompartmental Pressure Monitoring AP 130. Suture and Staple Removal 131. Wound Closure AP

Section Twenty-Two: Wound Management 132. Cleaning, Irrigating, Culturing, and Dressing an Open Wound 133. Débridement: Pressure Ulcers, Burns, and Wounds AP 134. Drain Removal 135. Fecal Containment Devices and Bowel Management System 136. Negative-Pressure Wound Therapy 137. Wound Management with Excessive Drainage

UNIT VIII: Nutrition 138. Percutaneous Endoscopic Gastrostomy (PEG), Gastrostomy, and Jejunostomy Tube Care 139. Small-Bore Feeding Tube Insertion and Care 140. Small-Bore Feeding Tube Insertion Using an Electromagnetic Guidance System (CORTRAK®)

NEW! UNIT IX: Calculating Medication Doses 141. Calculating Doses, Flow Rates, and Administration of Continuous Intravenous Infusions

Index