SINGLE / TRIPLE PRESSURE TRANSDUCER SYSTEM
After review/study of the CCNS Orientation manual and attendance at the CCNS orientation and skills laboratory, the learner will be able to:
PURPOSE: To monitor one or more pressure continuously using a single or triple transducer pressure tubing system.
|250cc NSS or Heparin flush solution||Single or
multiple disposable transducer with monitoring
kit & in-line syringe
||ECG monitor with
pressure monitoring module
|1. Assemble equipment. Wash hands.||1. Reduces transmission of microorganisms.|
|2. Plug transducer cable into monitor||2. For signal transmission to oscilloscope.|
|3. Set scale for pressure being measured.||3. Necessary for visualization of complete waveform and to obtain accurate readings. PAP usually on 40 mm Hg scale, CVP on a 30-mmHg scale, and arterial pressure according to patients systolic BP.|
|4. Obtain 250cc NSS or 250 U. Heparin/ 250cc NSS for flush bag.||4. Need physicians order for type f solution & document on medication sheet and I &Os section.|
|5. Label IV bag, tubing and time strip.||5. Validates times and promotes compliance with established standards.|
|6. Remove tubing/transducer from package, spike bag, invert and squeeze while pulling on fast flush device to remove air from bag.||6. Prevents accidental entry of air into tubing and patient via microbubbles that may dampen tracings and readings.|
|7. Tighten all tubing connections; maintain aseptic technique throughout assembly.||7. Connections will be loose from their sterilization process. Reduce risk of infection.|
|8. Open IV roller clamp, squeeze the drip chamber and fill to about 1/3 .||8. Prime drip chamber. Overfilling will prevent nurse from visualizing the flow during flushing.|
|9. Flush entire
system, including transducer, all stopcocks, and
pressure tubing. Replace any vented caps with
Leur-lok or "deadend" caps, and tighten
10. Place flush solution in a pressure bag and pump up pressure to 300 mmHg.
|9. Reduces risk
of micro air bubbles, dampened waveforms, &
inaccurate readings. Prevent fluid leaks and
reduce risk of infection.
10. Pressure is required to maintain flush device and at 300 mmHg will deliver 3 cc/hr.
|11. Level the
a. Position patient @ 0 to 45-degree angle.
b. Locate phlebostatic axis- level to right atrium, at the fourth intercostal space midaxillary line.
c. Place the carpenters level between the phlebostatic axis and the air-fluid interface of the transducer. Move the transducer up or down on the IV pole until the bubble is centered.
accuracy of heart pressure readings.
Serves as a reference point for consistency.
|12. Zero the
a. a. Open stopcock located on air-fluid interface to air (remove cap maintaining aseptic technique and close to the patient).
b. Push and release the zeroing button on monitor or handheld device. Observe the digital reading to fall to a "zero" value display.
c. Turn stopcock back to open system to patient. Ensure deadend cap reapplied.
a. So monitor can use atmospheric pressure as a reference for zero.
b. Zeroing negates the effects of atmospheric pressure so that only pressure values that are measured are the ones within the blood vessel or within the heart.
c. To resume monitoring the patient.
|13. Connect tubing to patient. (The first cable outlet in the Marquette system is set for arterial monitoring.) If the system is set up prior to connection to patient, re-zero after patient connection.||.|
|14. Activate the flush valve mechanism and evaluate the square wave test.||14. Inadequate square wave test is an indicator of unreliable readings.|
a. Flush bag q. 24 hours or with every new site
b. Pressure tubing down to site q. 72 hours or with every new site
c. Dressing (use Central Line Protocol) q. 72 hours or when loose
This page last updated 07/25/10
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