Manual of ICU Procedures

About the Book

The book has 61 chapters, covering almost all relevant procedures, including simple as well as more complex, done in critically and acutely ill patients.
Divided in 5 different sections, one each for airway & respiratory; vascular & cardiac; neurological; gastrointestinal, abdominal, genitourinary related procedures, and miscellaneous.
Written by experts with their vast experience and knowledge from various specialities.
Most of the chapters contain headings like introduction, indication, contraindication, applied anatomy, technique and equipment, preparation, procedure steps, the post-procedure care, and complication/problems associated with the procedure.
The highlighted feature of this book is that procedures are described step by step along with images.
Ready resource in ICU and emergency room.
This book will be helpful to various clinicians across specialty, including critical care physician, emergency physician, anesthetist, pulmonologist, pediatrician, general physician and general surgeon.

About the Author

Mohan Gurjar MD PDCC FICCM

Table of Contents:
Contents Section 1 Airway and Respiratory Procedures 1. Bag-Mask Ventilation 3 Ravinder Kumar Pandey, Rakesh Garg, V Darlong Indication 3 • Contraindication 4 • Applied Anatomy and Physiology 4 • Technique and Equipment 5 • Preparation 8 • Procedure 11 • Complication/Problem 15 2. Endotracheal Intubation 17 Pradeep Bhatia Indication 17 • Contraindication 17 • Applied Anatomy 18 • Technique and Equipment 18 • Preparation 20 • Procedure 24 • Post-Procedure Care 27 • Complication/Problem 27 3. Laryngeal Mask Airway Insertion 30 Neeta Bose Indication 30 • Contraindication 30 • Applied Anatomy 31 • Technique and Equipment 31 • Preparation 40 • Procedure 41 • Post-Procedure Care 45 • Complication/Problem 46 4. Fiberoptic Intubation 49 Amol Kothekar, JV Divatia Indication 49 • Contraindication 50 • Applied Anatomy 50 • Technique and Equipment 50 • Preparation 53 • Procedure 56 • Post-Procedure Care 59 • Complication/Problem 59 5. Video Laryngoscopy 62 Manish Paul, Banani Poddar • Indication 62 • Contraindication 63 • Technique and Equipment 63 • Preparation 64 • Procedure 65 • Complication/Problem 68 6. Double Lumen Endotracheal Tube Placement 71 Kamal Kishore Indication 71 • Contraindication 71 • Applied Anatomy 72 • Technique and Equipment 72 • Preparation 73 • Procedure (For Left Sided Double Lumen Tube) 74 • Post-Procedure Care 76 • Complication/Problem 76 7. Cricothyroidotomy 78 Kapil Dev Soni, Sanjeev Bhoi Indication 78 • Contraindication 78 • Applied Anatomy 79 • Technique 80 • Preparation 80 • Procedure 81 • Post-Procedure Care 88 • Complication/Problem 89 00__Contents.indd 19 27-06-2015 16:29:55 xx Manual of ICU Procedures 8. Percutaneous Tracheostomy 90 Devendra Gupta Indication 90 • Contraindication 90 • Applied Anatomy 91 • Technique and Equipment 92 • Preparation 102 • Procedure 103 • Post-Tracheostomy Care 110 • Complication/Problem 112 9. Surgical Tracheostomy 117 Kranti Bhavana, Amit Keshri Functions and Indications of Tracheostomy 117 • Contraindication 119 • Applied Anatomy 119 • Technique and Equipment 120 • Preparation 122 • Procedure 122 • Post-Procedure Care 125 • Complication/Problem 126 10. Bronchoscopy 129 Ravindra M Mehta, Rohan Aurangabadwalla Indication 129 • Contraindication 132 • Anatomical Details and Physiological Considerations 133 • Technique and Equipment 135 • Preparation 137 • Procedure 139 • Post-Procedure Care 142 • Complication/Problem 144 11. Bronchoalveolar Lavage (BAL) and Mini-BAL 146 Sanjay Singhal Indication 146 • Contraindication 147 • Technique 147 • Preparation 148 • Procedure 150 • Post-Procedure Care 151 • Complication/Problem 152 12. Thoracentesis 153 Pralay K Sarkar Indication 153 • Contraindication 153 • Applied Anatomy 153 • Technique and Equipment 154 • Preparation 155 • Procedure 157 • Post-Procedure Care 161 • Complication/Problem 161 13. Tube Thoracostomy 163 VN Maturu, Ritesh Agarwal Indication 163 • Contraindication 164 • Applied Anatomy 165 • Technique and Equipment 167 • Preparation 172 • Procedure 172 • Post-Procedure Care 180 • Complication/Problem 181 14. Non-invasive Ventilation for Acute Respiratory Failure 187 Raj Kumar Mani, Prashant Saxena Indications of Non-invasive Ventilation 187 • Contraindications of Non-invasive Ventilation 188 • Technique and Basic Principles of Non-invasive Ventilation 188 • Preparation for Non-invasive Ventilation 194 • Starting, Monitoring and Weaning of Non-invasive Ventilation 196 • Complications of Non-invasive Ventilation 198 15. Aerosol Drug Delivery 200 Sanjay Singhal, Mohan Gurjar Indications for Uses of Aerosol Therapy 200 • Contraindication 200 • Principles of Aerosol Therapy 200 • Preparation 205 • Procedures for Delivering Aerosol Therapy 205 • Post-Procedure Care 208 • Complication and Preventive Measures 209 00__Contents.indd 20 27-06-2015 16:29:55 Contents xxi 16. Prone Positioning 210 Puneet Khanna, Girija Prasad Rath Indication 210 • Contraindication 210 • Applied Anatomy and Pathophysiology 211 • Clinical Aspect and Technique 212 • Preparation 214 • Procedure 215 • Post-Procedural Care 215 • Complication/Problem 216 17. Manual Chest Physiotherapy in Ventilated Patients 218 Rajendra Kumar Indication 218 • Contraindication 219 • Applied Anatomy 219 • Technique 221 • Preparation 225 • Procedure 225 • Post-Procedure Care 231 • Complication/Problem 232 Section 2 Vascular and Cardiac Procedures 18. Venous Cannulation: Peripheral 237 Nikhil Kothari, Arun Sharma Indication 237 • Contraindication 237 • Applied Anatomy 238 • Technique and Equipment 239 • Preparation 241 • Procedure 241 • Post-Procedure Care 242 • Complication/Problem 243 19. Venous Cannulation: Central Venous Catheter 246 Afzal Azim, Abhishek Kumar Indication 246 • Contraindication 246 • Applied Anatomy 247 • Technique and Equipment 247 • Preparation 253 • Procedure 253 • Post-Procedure Care 258 • Complication/Problem 258 20. Venous Cannulation: Peripherally Inserted Central Catheter 261 Vandana Agarwal, Atul P Kulkarni Indication 261 • Contraindication 261 • Applied Anatomy 261 • Technique and Equipment 262 • Preparation 263 • Procedure 264 • Post-Procedure Care 265 • Complication/Problem 266 21. Tunneling of Central Venous Catheter 268 Dharmendra Bhadauria, Vivek Ruhela Indication 268 • Contraindication 268 • Applied Anatomy 269 • Technique and Equipment 270 • Preparation 270 • Procedure 271 • Complication/Problem 272 22. Intraosseous Cannulation 276 Nishant Verma, Rakesh Lodha Indication 276 • Contraindication 276 • Applied Anatomy 277 • Technique and Equipment 277 • Preparation 279 • Procedure 280 • Post-Procedure Care 286 • Complication/Problem 287 23. Umbilical Vascular Catheterization 288 Kirti M Naranje, Banani Poddar Indication 288 • Contraindication 289 • Applied Anatomy 289 • Technique and Equipment 289 • Preparation 292 • Procedure 293 • Post-Procedure Care 296 • Complication/Problem 296 00__Contents.indd 21 27-06-2015 16:29:55 xxii Manual of ICU Procedures 24. Arterial Blood Sampling and Cannulation 298 Afzal Azim, Saurabh Saigal Indication 298 • Contraindication 299 • Applied Anatomy 299 • Technique and Equipment 299 • Preparation 302 • Procedure 303 • Post-Procedure Care 307 • Complication/Problem 308 25. Pulmonary Artery Catheterization 309 Puneet Goyal Indication 309 • Contraindication 310 • Applied Anatomy 310 • Technique and Equipment 311 • Preparation 312 • Procedure 314 • Post-Procedure Care 320 • Complication/Problem 320 26. Transducer and Pressure Monitoring 322 Jyoti Narayan Sahoo Indication 322 • Technique and Basic Principles of Pressure Transducer 323 • Transducer Preparation and Pressure Measurement 328 • Troubleshooting 333 27. Pericardiocentesis 336 Jugal Sharma, Aditya Kapoor Indication 336 • Contraindication 336 • Applied Anatomy and Physiology 336 • Technique 338 • Preparation 339 • Procedure 340 • Post-Procedure Care 343 • Complication/Problem 344 28. Electrical Cardioversion 345 Saurabh Taneja, Sumit Ray Indication 345 • Contraindication 345 • Applied Physiology and Anatomy 346 • Technique and Equipment 346 • Preparation 349 • Procedure 350 • Post-Procedure Care 350 • Complication/Problem 352 29. Temporary Cardiac Pacing 353 Saswata Bharati, Nirvik Pal, Devesh Dutta Indication 353 • Contraindication 354 • Technique and Basic Principles 355 • Preparation 362 • Procedure 362 • Post-Procedure Care 364 • Complication/Problem 365 30. Intra-aortic Balloon Pump Counterpulsation 367 Virendra K Arya Indication 367 • Contraindication 368 • Technique: Basic Principles 368 • Technique: Insertion and Operation 374 • Main Points of Care 380 • Weaning from Intra-Aortic Balloon Pump Counterpulsation 381 • Complication/Problem 381 • Special Situations 382 • Permanent Intra-Aortic Balloon Pump 383 31. Tourniquet for Vascular Injuries 386 Sushma Sagar, Kamal Kataria Indication 386 • Contraindication 386 • Applied Physiology 387 • Technique 387 • Preparation and Procedure 388 • Post-Procedure Care 389 • Complication/Problem 390 00__Contents.indd 22 27-06-2015 16:29:56 Contents xxiii Section 3 Neurological Procedures 32. Jugular Venous Oximetry 395 Hemant Bhagat Indication 395 • Contraindication 395 • Applied Anatomy 395 • Technique and Basic Principles 396 • Preparation 397 • Procedure 397 • Post-Procedure Care 398 • Complication/Problem 399 33. Lumbar Puncture 401 Bhaskar P Rao, Neha Singh Indication 401 • Contraindication 402 • Applied Anatomy 402 • Technique and Equipment 403 • Preparation 408 • Procedure 408 • Post-Procedure Care 411 • Complication/Problem 412 34. Epidural Analgesia 415 Sanjay Dhiraaj Indication 415 • Contraindication 416 • Applied Anatomy 416 • Technique and Basic Principles of Epidural Analgesia 417 • Preparation 421 • Procedure 421 • Post-Procedure Care 427 • Complication/Problem 427 35. Cranial Burr Hole 430 Rabi N Sahu, Kuntal Kanti Das, Arun K Srivastava Indication 430 • Contraindication 430 • Applied Anatomy 431 • Preparation 431 • Procedure 432 • Post-Procedure Care 433 • Complication/Problem 434 36. External Ventricular Drainage 435 Devesh K Singh, Arun K Srivastava, Kuntal Kanti Das, Rabi N Sahu Indication 435 • Contraindication 436 • Applied Anatomy and Physiology 436 • Technique and Basic Principles 439 • Preparation 442 • Procedure 442 • Post-Procedure Care 443 • Complication/Problem 445 37. Intracranial Pressure Monitoring 447 Hemanshu Prabhakar Indication 447 • Contraindication 448 • Applied Anatomy and Physiology 448 • Technique and Equipment 449 • Preparation 451 • Procedure 452 • Post-Procedure Care 452 • Complication/Problem 453 38. Nerve and Muscle Biopsy 454 Sanjeev K Bhoi, Jayantee Kalita, Usha K Misra Indication 454 • Contraindication 454 • Technique and Basic Principles 455 • Preparation 456 • Procedure 456 • Post-Procedure Care 459 • Complication/Problem 459 00__Contents.indd 23 27-06-2015 16:29:56 xxiv Manual of ICU Procedures 39. Spine Immobilization in Trauma Patient 460 Sandeep Sahu, Indu Lata Indication 461 • Contraindication of Spine Immobilization 461 • Applied Spine Anatomy 461 • Technique and Equipment 463 • Preparation 466 • Procedure Steps of Spine Immobilization and Logrolling 468 • Spine Immobilization During Imaging and Transport 470 • Post-Procedure Care 470 • Complication/Problem 471 Section 4 Gastrointestinal/Abdominal/Genitourinary Procedures 40. Nasogastric Tube Placement 477 Bhuwan Chand Panday Indication 477 • Contraindication 477 • Applied Anatomy 478 • Technique and Equipment 478 • Preparation 481 • Procedure 481 • Post-Procedure Care 483 • Complication/Problem 483 41. Nasojejunal Tube Placement 486 Zafar Neyaz, Praveer Rai, Hira Lal Indication 486 • Contraindication 486 • Applied Anatomy 486 • Technique and Equipment 487 • Preparation 488 • Procedure 489 • Post-Procedure Care 494 • Complication/Problem 495 42. Percutaneous Endoscopic Gastrostomy 497 Samir Mohindra, Kundan Kumar Indication 497 • Contraindication 498 • Technique and Equipment 498 • Preparation 499 • Procedure 500 • Post-Procedure Care 502 • Complication/Problem 504 43. Balloon Tamponade in Upper GI Bleed 506 Praveer Rai Indication 506 • Contraindication 506 • Technique and Equipment 506 • Preparation 508 • Procedure 508 • Post-Procedure Care 509 • Complication/Problem 510 44. Gastric Lavage 512 Manish Gupta, Nitin Garg Indication 512 • Contraindication 513 • Technique 513 • Preparation 515 Procedure 515 • Post-Procedure Care 517 • Complication/Problem 518 45. Intra-abdominal Pressure Monitoring 520 RK Singh Indication 520 • Contraindication 521 • Applied Pathophysiology 521 • Technique 521 • Preparation 522 • Procedure 522 • Post-Procedure Care 525 • Complication/Problem 525 46. Paracentesis 527 Prasad Rajhans, Divyesh Patel Indication 527 • Contraindication 527 • Applied Anatomy 528 • Technique 528 • Preparation 529 • Procedure 530 • Post-Procedure Care 534 • Complication/Problem 535 00__Contents.indd 24 27-06-2015 16:29:56 Contents xxv 47. Percutaneous Abdominal Drain 537 Hira Lal, Rajanikant R Yadav, Zafar Neyaz Indication 537 • Contraindication 537 • Applied Anatomy 537 • Technique and Equipment 538 • Preparation 540 • Procedure 541 • Post-Procedure Care 549 • Complication/Problem 549 48. Bedside Laparoscopy 552 Biju Pottakkat Indication 552 • Contraindication 553 • Preparation 553 • Technique and Equipment 553 • Procedure 554 • Post-Procedure Care 555 • Complication/Problem 555 49. Dynamic Abdominal Wall Closure for Open Abdomen 556 Fahri Yetisir, A Ebru Salman, Oskay Kaya Indication 556 • Contraindication 556 • Technique 558 • Preparation 558 Procedure 559 • Post-Procedure Care 560 • Complication/Problem 561 50. Urethral Catheterization 563 Vijai Datta Upadhyaya, Eti Sthapak Indication 563 • Contraindication 563 • Applied Anatomy 564 • Technique and Equipment 564 • Preparation 566 • Procedure (In Male Patient) 566 • Post-Procedure Care 572 • Complication/Problem 572 51. Suprapubic Cystostomy 574 Vijai Datta Upadhyaya Indication 574 • Contraindication 574 • Applied Anatomy 575 • Technique and Equipment 576 • Preparation 577 • Procedure 577 • Post-Procedure Care 578 • Complication/Problem 581 52. Peritoneal Dialysis Catheter Placement 585 Basant Kumar, MS Ansari Indication 586 • Contraindication 586 • Applied Anatomy 587 • Technique and Equipment 587 • Preparation 590 • Procedure 592 • Post-Procedure Care 595 • Complication/Problem 596 53. Hemodialysis 598 Harsh Vardhan, Dharmendra Bhadauria Indication 598 • History and Basic Principle 598 • Modalities of Renal Replacement Therapy 599 • Preparation 608 • Procedure 608 • Post-Procedure Care 610 • Complication/Problem 610 Section 5 Miscellaneous 54. Bone Marrow Aspiration and Biopsy 615 Gaurav Srivastava, Barnali Banik, Narendra Agrawal Indication 615 • Contraindication 616 • Applied Anatomy 616 • Technique and Equipment 616 • Preparation 618 • Procedure 619 • Post-Procedure Care 623 • Complication/Problem 623 00__Contents.indd 25 27-06-2015 16:29:56 xxvi Manual of ICU Procedures 55. Postmortem Organ Needle Biopsy 625 Rajanikant R Yadav, Namita Mehrotra • Indication 625 • Contraindication 625 • Applied Anatomy and Technique 626 • Preparation 626 • Procedure 627 • Post-Procedure Care and Problems 628 56. Managing Pressure Ulcer 631 Ankur Bhatnagar Pathophysiology of Pressure Ulcer 631 • Prevention 632 • Treatment of Pressure Ulcer 636 • Preparation 636 • Procedure 641 57. Mobilization of Patient 646 Abraham Samuel Babu, Vishal Shanbhag, Arun G Maiya Indication for Early Mobilization 646 • Contraindication for Early Mobilization 646 • Technique and Basic Principles of Mobilization 647 • Preparation and Assessment 650 • Physiotherapy Treatment 652 • Post-Procedure Care 655 • Complication/Problem 656 58. Surveillance of ICU-acquired Infection 658 Armin Ahmed, Richa Misra Objective 658 • ICU-acquired Infection and Surveillance System 658 • Method of Surveillance: Basic Principles 660 • Surveillance for Specific ICU-acquired Infection 662 59. Blood and Urine Sampling for Microbiology 667 Armin Ahmed Blood Sampling 667 • Technique and Basic Principles (Blood Sampling) 668 • Preparation and Procedure (Blood Sampling) 669 • Post-Procedure Care (Blood Sampling) 671 • Urine Sampling 671 • Technique and Basic Principle (Urine Sampling) 671 • Preparation and Procedure (Urine Sampling) 671 • Post-Procedure Care (Urine Sampling) 673 60. Blood Component Handling at Bedside 674 Atul Sonker, Anju Dubey Blood Components: Basic Properties 674 • Bedside Handling of Blood Components 678 • Adverse Reaction Due to Blood Components 684 61. Managing Needle-Stick Injury 690 Puja Srivastava, Anupam Wakhlu, Vikas Agarwal Definitions 690 • Prevention From Needle-Stick Injury 691 • Post-Exposure Prophylaxis 692 • Post-Exposure Counseling 699 Index 703 00__Contents.indd 26 27-06-2015 16:29:56