Common Emergency Department Procedures

Emergency Department care may include bedside assessment, monitoring, diagnostic testing, medication, wound care, injury management, breathing support, and emergency treatment. The procedures used depend on a person’s symptoms, condition, medical history, and level of urgency. Some procedures are performed immediately, while others are performed after further evaluation and discussion with the care team.

Assessment and monitoring

Triage assessment: The initial clinical assessment used to determine how urgently a person needs care and where they should be evaluated.
Vital signs measurement: Checking measurements such as temperature, heart rate, breathing rate, blood pressure, and oxygen saturation.
Pulse oximetry: A noninvasive measurement that estimates the oxygen level in the blood using a sensor placed on a finger, toe, or earlobe.
Cardiac monitoring: Ongoing monitoring of the heart’s electrical activity, heart rate, and rhythm.
Blood pressure monitoring: Measuring the force of blood against the walls of the blood vessels, sometimes repeatedly or continuously during emergency care.
Neurologic assessment: An examination of alertness, speech, movement, strength, sensation, pupils, and other signs of brain and nerve function.
Reassessment: A repeat evaluation to determine whether symptoms, vital signs, or the response to treatment have changed.

Diagnostic procedures and tests

Venipuncture: Inserting a needle into a vein to collect a blood sample for laboratory testing or to establish access for treatment.
Blood test: Laboratory testing of a blood sample to evaluate factors such as infection, inflammation, blood counts, electrolytes, or organ function.
Urinalysis: Testing a urine sample for signs of infection, blood, dehydration, kidney problems, or other conditions.
Electrocardiogram (ECG or EKG): A test that records the heart’s electrical activity and can help identify certain heart rhythm or circulation problems.
X-ray: An imaging test that uses a small amount of radiation to create pictures of bones and certain organs or tissues.
Computed tomography (CT) scan: An imaging test that uses X-rays and computer processing to create detailed cross-sectional images of the body.
Ultrasound: An imaging test that uses sound waves to create pictures of internal organs, blood vessels, or developing tissue.
Point-of-care testing: Testing performed near the person receiving care, often using a small blood or urine sample to obtain results quickly.
Contrast administration: Giving a contrast material during some imaging tests so that certain organs, blood vessels, or tissues are easier to see.

Medication and supportive procedures

Intravenous (IV) access: Placing a small, flexible tube in a vein so healthcare professionals can give fluids, medication, blood products, or other treatment.
IV fluid administration: Giving fluids through a vein to support hydration, circulation, or replacement of fluid losses.
Medication administration: Giving medication by a route such as by mouth, injection, inhalation, or IV to treat symptoms or an underlying condition.
Oxygen therapy: Providing supplemental oxygen through a nasal cannula, face mask, or another breathing device.
Nebulizer treatment: Turning liquid medication into a mist that can be inhaled into the lungs.
Blood transfusion: Giving blood or a blood component through an IV to replace blood loss or treat a blood-related condition.
Local anesthetic: Medication applied or injected to numb a specific area and reduce pain during a procedure.
Procedural sedation: Medication used to reduce anxiety, discomfort, or awareness during a procedure. The level of sedation and required monitoring depend on the medication and procedure.
Tetanus vaccination: Giving a vaccine to help protect against tetanus when a wound or other exposure creates a risk and vaccination is indicated.

Wound and soft-tissue procedures

Wound assessment: Examining a wound for its depth, location, contamination, damage to nerves or blood vessels, and possible involvement of muscles, tendons, or bone.
Wound irrigation: Rinsing a wound with fluid to remove dirt, debris, or other contaminants.
Foreign body removal: Removing an object, such as glass, metal, or other material, that has become embedded in or entered the body.
Laceration repair: Closing a cut or tear in the skin with stitches, staples, adhesive strips, or medical adhesive.
Sutures: Stitches used to close a wound or incision and support healing.
Staples: Metal closures used to bring the edges of some wounds or surgical incisions together.
Medical adhesive: A skin adhesive used to close selected wounds without placing stitches or staples.
Incision and drainage: A procedure in which a clinician opens and drains a collection of pus, such as an abscess.
Wound dressing: Applying a protective covering to help protect a wound, absorb drainage, and support healing.
Burn care: Cleaning, assessing, covering, and treating a burn according to its depth, size, location, and cause.

Musculoskeletal and injury procedures

Splinting: Applying a support to protect an injured body part and limit movement. A splint may allow room for swelling.
Casting: Applying a rigid support to hold an injured bone or joint in place while it heals.
Immobilization: Limiting movement of an injured body part or the spine to help prevent additional injury.
Reduction: Moving a dislocated joint or a broken bone back toward its normal alignment.
Joint aspiration: Using a needle to remove fluid from a joint for testing or to relieve pressure when clinically appropriate.
Crutch or mobility-aid fitting: Adjusting and explaining the use of crutches or another mobility aid to support safe movement after an injury.

Airway and breathing procedures

Airway positioning: Adjusting the position of the head, neck, or body to help keep the airway open.
Airway suctioning: Removing mucus, blood, vomit, or other material from the mouth or airway to support breathing.
Bag-valve-mask ventilation: Using a hand-operated mask and bag to provide breaths when a person is not breathing adequately.
Intubation: Placing a breathing tube into the trachea to help keep the airway open and support breathing.
Mechanical ventilation: Using a machine to assist or control breathing when a person cannot breathe adequately on their own.
Noninvasive ventilation: Providing breathing support through a mask rather than a breathing tube, when clinically appropriate.
Chest tube insertion: Placing a tube into the chest to remove air, blood, or fluid and help the lung or chest function properly.

Emergency treatments and resuscitation

Cardiopulmonary resuscitation (CPR): Emergency chest compressions, with rescue breaths when appropriate, to help maintain circulation and breathing during cardiac arrest.
Defibrillation: Delivering an electrical shock to treat certain life-threatening abnormal heart rhythms.
Cardioversion: Using a synchronized electrical shock or medication to help restore a regular heart rhythm.
Electrical pacing: Using electrical impulses to help maintain a heart rate when the heart is beating too slowly or the normal electrical system is not working effectively.
Resuscitation: Immediate treatment to support or restore essential functions such as breathing and circulation.

Tubes, drainage, and other procedures

Urinary catheterization: Inserting a flexible tube into the bladder to drain urine, monitor urine output, or assist with treatment.
Nasogastric tube placement: Passing a flexible tube through the nose into the stomach to remove stomach contents, deliver medication or nutrition, or support treatment.
Central venous access: Placing a catheter into a large vein to give certain medications or fluids, obtain access when regular IV access is difficult, or monitor treatment.
Lumbar puncture: Inserting a needle into the lower back to collect a sample of cerebrospinal fluid for testing.
Procedural drainage: Using a needle, catheter, or tube to remove fluid, blood, air, or pus from a body space or collection.

Care after a procedure

Post-procedure monitoring: Observing a person after a procedure to check vital signs, breathing, pain, bleeding, the effect of medication, and possible complications.
Observation: Continued monitoring and treatment for a limited period to determine whether a person improves, needs more care, or can safely leave.
Discharge instructions: Written or verbal information about wound care, medications, activity, follow-up appointments, and symptoms that require additional medical attention.
Return precautions: Specific warning signs that mean a person should contact a healthcare professional or return for urgent care.
Follow-up: Additional evaluation or care after the Emergency Department visit, such as an appointment with a primary care professional or specialist.

The exact procedures performed in an Emergency Department vary according to the person’s condition, available services, clinical judgment, and level of urgency. Healthcare professionals should explain the purpose, expected benefits, possible risks, and aftercare for a procedure whenever the situation allows.