Cardiac Monitoring - Swan-Gantz
I. Other Names Pulmonary Artery Catheter, PA Catheter, Swan, Swan-Gantz, Flow-directed thermodilutional multilumen)

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.
Prepare equipment.
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 added.
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.

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