ACEM - Procedural Skills

Procedural Skills

Procedural skills (PS) remain a high-level requirement central to the practice of emergency medicine (EM). The comprehensive Core and Scope of Practice skills list has been maintained with the inclusion of Pre-Hospital and Retrieval Medicine critical CPD procedural skills. Download the Procedural Skills, or view them below.

Please note, the annual core procedural skills can be conducted in a clinical or simulated setting, by performance, teaching or supervision.

Core Skills
- Airway
- Breathing
- Circulation
Scope of Practice Skills

Clinical skills relevant to emergency medicine practice including analgesia, ENT, eyes, fluids, minor surgical, O&G, orthopaedics, toxicology, trauma, ultrasound and urology.

You will find the core procedural skills (airway, breathing and cirulation) are duplicated in the scope of practice list (alphabetiacal order). These core procedural skills may be recorded as scope of practice skills after you have met your annual core procedural skills requirements.

List of Procedural Skills

2022 CPD Procedural Skills

This list of Procedural Skills is relevant to the ACEM CPD program. Participation in any of these activities / procedural skills is not to be used for credentialling purposes.

ACTIVITY TYPE	ACTIVITY (PROCEDURAL SKILL)
Airway	Emergency replacement of blocked or dislodged tracheostomy tube
Airway	Flexible - Fibre-optic
Airway	Insertion - Cricothyroid needle
Airway	Insertion - Laryngeal mask airway
Airway	Insertion - Seldinger / needle or surgical cricothyroidotomy
Airway	Intubation - direct laryngoscopy
Airway	Intubation - video laryngoscopy
Airway	Percutaneous tracheostomy
Airway	Use of an additional difficult airway device
Breathing	Bag valve mask ventilation
Breathing	Drainage of pleural effusion
Breathing	Jet insufflation
Breathing	Microcatheter insertion
Breathing	Needle decompression of pneumothorax
Breathing	Needle thoracocentesis
Breathing	Set up of ventilator & commencement of positive pressure ventilation
Breathing	Thoracostomy - Decompressive
Breathing	Thoracostomy - Tube
Breathing	Use of non-invasive ventilation device – Adult
Breathing	Use of non-invasive ventilation device - Child
Circulation	Cardiac procedures - External cardiac pacing
Circulation	Cardiac procedures – Pericardiocentesis
Circulation	Defibrillation / DC Cardioversion
Circulation	External Chest Compressions - Adult, child or infant
Circulation	Insertion of temporary pacing wire
Circulation	Newly born resuscitation
Circulation	Resuscitative thoracotomy
Circulation	Vascular access - Arterial Line insertion
Circulation	Vascular access - Central venous
Circulation	Vascular access - Central venous - Ultrasound guided
Circulation	Vascular access – Intraosseous
Circulation	Vascular access - Large bore intravenous : ≥ 14G / Insertion of a rapid infusion catheter
Circulation	Vascular access - Paediatric venous access : age <2 year old
Circulation	Vascular access - Paediatric venous access : aged between 2 and 15 years old
Circulation	Vascular access - Peripheral Inserted Central Catheter (PICC)
Circulation	Vascular access - Umbilical vein
Circulation	Vascular access - Venous cutdown
Scope of Practice	Airway - Basic Life Support – Adult
Scope of Practice	Airway - Basic Life Support – Child
Scope of Practice	Airway - Extubation
Scope of Practice	Airway - Insert nasopharyngeal airway

Scope of Practice	Airway - Insert oropharyngeal airway
Scope of Practice	Airway - Securing and caring for ETT including during transport
Scope of Practice	Airway – Upper airway topicalisation
Scope of Practice	Circulation - Advanced Life Support - ExtraCorporeal Membrane Oxygenation (ECMO)
Scope of Practice	Circulation - Advanced Life Support - Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
Scope of Practice	Circulation - Basic Life Support - Initiation of Automated External Cardiac Pressure (AECP)
Scope of Practice	Circulation – Escharotomy
Scope of Practice	Circulation – Ice water cardioversion
Scope of Practice	Circulation – PPH management including use of uterine balloon tamponade
Scope of Practice	Chemical-Biological-Radiological (CBR) Response - full suit
Scope of Practice	Dental - Enlocation avulsed / extruded / intruded / laterally injured tooth
Scope of Practice	Dental - Joint reduction - Temporo-mandibular joint
Scope of Practice	ENT - Anterior nasal packing
Scope of Practice	ENT - Aural wick insertion
Scope of Practice	ENT - Nasopharyngeal aspirate collection
Scope of Practice	ENT - Posterior nasal packing
Scope of Practice	ENT - Removal of aural foreign bodies
Scope of Practice	ENT - Removal of laryngeal foreign bodies
Scope of Practice	ENT - Removal of nasal foreign bodies
Scope of Practice	Environmental - Advanced cooling techniques
Scope of Practice	Environmental - Advanced warming techniques
Scope of Practice	Eyes - Lateral canthotomy and cantholysis
Scope of Practice	Eyes - Removal of corneal foreign bodies
Scope of Practice	Eyes – Tonometry
Scope of Practice	Fluids - Abdominal paracentesis / insertion of drain
Scope of Practice	Fluids - Emergency replacement of a dislodged gastrostomy tube
Scope of Practice	Fluids - Insertion of a nasogastric tube or orogastric tube
Scope of Practice	Fluids - Insertion of a suprapubic catheter
Scope of Practice	Fluids - Insertion of an infant urinary catheter (female and male)
Scope of Practice	Fluids – Rapid infusion (pump giving sets, pressure bags, blood warmer)
Scope of Practice	Fluids - Replacement of a suprapubic catheter
Scope of Practice	Fluids - Suprapubic aspiration
Scope of Practice	Fluids - Use of oesophageal balloon tamponade in massive GI bleed
Scope of Practice	Microbiology - Lumbar puncture NS – S32
Scope of Practice	Minor Surgical - Advanced suturing techniques
Scope of Practice	Minor Surgical - Drainage of peritonsillar abscess
Scope of Practice	Minor Surgical - Incision and drainage of abscesses
Scope of Practice	Minor Surgical - Nail bed repair
Scope of Practice	Minor Surgical - Removal of superficial & subcutaneous foreign bodies
Scope of Practice	Minor Surgical - Wound exploration, cleaning, irrigation, and debridement
Scope of Practice	O & G - Post Partum Haemorrhage management (including use of uterine balloon tamponade)
Scope of Practice	O & G - Removal of products of conception from cervical os
Scope of Practice	O & G – Resuscitative hysterotomy
Scope of Practice	O & G - Spontaneous vaginal delivery and delivery of placenta

Scope of Practice	O & G - Vaginal foreign body removal
Scope of Practice	Orthopaedics - Application of a pelvic binding device
Scope of Practice	Orthopaedics - Application of traction splinting devices
Scope of Practice	Orthopaedics - Arthrocentesis (ankle)
Scope of Practice	Orthopaedics - Arthrocentesis (elbow)
Scope of Practice	Orthopaedics - Arthrocentesis (knee)
Scope of Practice	Orthopaedics - Arthrocentesis (other joints)
Scope of Practice	Orthopaedics - Arthrocentesis (shoulder)
Scope of Practice	Orthopaedics - Emergent fracture / Dislocation reduction
Scope of Practice	Orthopaedics - Fracture / Joint immobilisation - Slab / Plaster application
Scope of Practice	Orthopaedics - Fracture reduction - Ankle
Scope of Practice	Orthopaedics - Fracture reduction - Lower limb other
Scope of Practice	Orthopaedics - Fracture reduction - Upper limb other
Scope of Practice	Orthopaedics - Fracture reduction – Wrist
Scope of Practice	Orthopaedics - Insertion of a fascial intra-compartmental monitor
Scope of Practice	Orthopaedics - Joint reduction - Digits
Scope of Practice	Orthopaedics - Joint reduction – Elbow
Scope of Practice	Orthopaedics - Joint reduction – Hip
Scope of Practice	Orthopaedics - Joint reduction - Knee/Patella
Scope of Practice	Orthopaedics - Joint reduction – Other
Scope of Practice	Orthopaedics - Joint reduction – Shoulder
Scope of Practice	Orthopaedics - Maintain in line stabilisation during airway intervention
Scope of Practice	Regional Anaesthesia - Brachial plexus block
Scope of Practice	Regional Anaesthesia - Femoral or fascia iliaca block
Scope of Practice	Regional Anaesthesia - Intravenous regional anaesthesia
Scope of Practice	Regional Anaesthesia - Regional nerve blocks
Scope of Practice	Regional Anaesthesia – Joint/Fracture injection, anaesthesia Shoulder/Wrist +/- US Guided
Scope of Practice	Sedation delivery - Administration of IM or IV sedation for chemical restraint
Scope of Practice	Sedation delivery - Administration of inhaled procedural sedation
Scope of Practice	Sedation delivery - Administration of IV sedation for procedures
Scope of Practice	Trauma – Application of arterial tourniquet use
Scope of Practice	Trauma – Cranial Decompression
Scope of Practice	Trauma – Junctional haemorrhage control techniques
Scope of Practice	Trauma – Maxillofacial haemorrhage control
Scope of Practice	Trauma - Retrieval limb amputation
Scope of Practice	Toxicology - Gastric decontamination
Scope of Practice	Toxicology - Whole Bowel Irrigation
Scope of Practice	Ultrasound - Abdominal aortic aneurysm
Scope of Practice	Ultrasound - Application of haemodynamic assessment protocols
Scope of Practice	Ultrasound - Assessment in undifferentiated shock / Rapid Ultrasound for Shock & Hypotension (RUSH)
Scope of Practice	Ultrasound - Bedside echocardiography including arrest
Scope of Practice	Ultrasound - Detection & characterisation of an abdominal aortic aneurysm
Scope of Practice	Ultrasound - (Extended) Focussed Assessment with Sonography for Trauma ((E)FAST)
Scope of Practice	Ultrasound - Guided Peripheral Vascular Access NS - C16
Scope of Practice	Ultrasound - Hepatobiliary ultrasound
Scope of Practice	Ultrasound - Lung
Scope of Practice	Ultrasound - Ocular

Scope of Practice	Ultrasound - Pregnancy - 1st trimester
Scope of Practice	Ultrasound - Pregnancy - 2nd and 3rd trimester
Scope of Practice	Ultrasound - Renal tract ultrasound
Scope of Practice	Ultrasound - Soft tissue ultrasound
Scope of Practice	Ultrasound - Ultrasound guided nerve blocks
Scope of Practice	Urology – Indwelling Catheter (IDC) Guidewire Insertion
Scope of Practice	Urology – Insertion of 3-way adult urinary catheter (male and female) and undertaking a manual bladder washout
Scope of Practice	Urology - Procedural management of priapism
Scope of Practice	Urology - Reduction of paraphimosis

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