Cardiac Monitoring -
I. Other Names Pulmonary Artery Catheter, PA
Catheter, Swan, Swan-Gantz, Flow-directed thermodilutional
II. Description Ports/lumens.
1. CVP Proximal (injectate port for CO)
2. PA Distal (Pressure line hook up)
Markings on catheter.
1. Each thin line=10 cm.
2. Each thick line=50 cm.
1. Allows for continous bedside hemodynamic monitoring.
Vascular tone, myocardial contractility, and fluid balance can be
correctly assessed and managed.
2. Measures Pulmonary Artery Pressures, CVP, and allows for
hemodynamic calculated values.
3. Measures Cardiac Output. (Thermodilution)
4. SvO2 monitoring (Fiber optic).
5. Transvenous pacing.
6. Fluid administration.
III. Insertation of PA Catheter.
1. Turn on monitor.
2. Select PA Catheter.
3. Select Introducer.
4. Set up pressure monitoring system.
a. Flush-Fluid (500cc bag Normal Saline with 1000u Heparin
b. Transducer and pressure tubing (non-distensible).
c. Pressure bag.
d. Pressure cable.
5. Zero and calibrate bedside monitor.
6. Check balloon integrity on PA catheter.
7. Assist with insertion of introducer (central line).
8. PA Catheter is attached to pressure line. Then inserted
thru introducer, into vena cava, When PA catheter enters
right atrium, a wave form and pressure registers on the
monitor. The MD requests that the balloon be inflated. The
inflated balloon acts as a sail to "float" the tip
of the catheter down stream to the pulmonary artery.
Pressures and wave forms change as the tip of the catheter
enters the Right Ventricle, again as it enters the pulmonary
artery, and then again as the balloon is wedged in an artery
that is to small to allow the baloon to go any further.
9. Chest X-ray/Sterile Dressing.
Return to Nurse Bob's Page