In order to be able to carry out effective emergency medicine outside the hospital, knowledge of some of the important puncture techniques is essential. Sometimes injection and infusion is required under difficult conditions, and sometimes decompression punctures are the vitally decisive interventions. Among these are central venous access via the subclavian vein, intracardial injection, decompression puncture in cardiac tamponade, relief of tension pneumothorax, cannulation of the trachea and relief of mediastinal emphysema. These interventions are outlined according to indication, technique and complications.