In an emergency, the registrar asks you to place an intercostal catheter and you have never done one before. What should you do first?

In an emergency, the registrar asks you to place an intercostal catheter and you have never done one before. What should you do first?

• A. You would inform them you've never put one in before and that you'd be uncomfortable doing it.
• B. Have to keep in mind patient safety and that you could be doing more harm than good if you insert the ICC.
• C. At least collect the equipment and set up if you know how to.
• D. Call cardiothoracics/respiratory team if needed.

Answer: (A)

Recognizing your limits and seeking supervision is essential when asked to perform a procedure you haven’t been trained for. If you’ve never inserted an intercostal catheter, the safest first step is to tell the registrar that you haven’t done this before and would be uncomfortable attempting it. This clearly communicates your lack of training, protects the patient from potential harm, and prompts immediate supervision or handover to a trained clinician. In an emergency, you still prioritize patient safety over action; you don’t proceed with an invasive procedure you’re not competent to perform. While it’s important to want to help and to escalate care, simply thinking about safety or collecting equipment without appropriate training can lead to harm, and calling in a senior team is appropriate but should follow the acknowledgment of your limits so they can provide proper guidance and supervision.

Recognizing your limits and seeking supervision is essential when asked to perform a procedure you haven’t been trained for. If you’ve never inserted an intercostal catheter, the safest first step is to tell the registrar that you haven’t done this before and would be uncomfortable attempting it. This clearly communicates your lack of training, protects the patient from potential harm, and prompts immediate supervision or handover to a trained clinician. In an emergency, you still prioritize patient safety over action; you don’t proceed with an invasive procedure you’re not competent to perform. While it’s important to want to help and to escalate care, simply thinking about safety or collecting equipment without appropriate training can lead to harm, and calling in a senior team is appropriate but should follow the acknowledgment of your limits so they can provide proper guidance and supervision.