Swan Ganz catheters

Most adult patients return with Swan-Ganz catheters in place. These devices should be inspected to ensure that the point of entry into the skin is appropriately covered with antibiotic ointment and dressing. Patients should be tested. Appropriate wave tracings should be analyzed.

The device is used for three primary purposes:

1. Determine pressure measurements (RA, PA, pulmonary capillary wedge)

2. Determine cardiac output (thermodilution technique)

3. Determine the mixed venous O2 saturation. When determining pressures, care should be taken to ensure that the transducer functions. When analyzing cardiac output, appropriate volumes and temperatures of injectables should be checked along with the appropriate computer constant entered in the thermodilution computer. When obtaining mixed venous O2 saturations, the distal port of the Swan should be used to obtain pulmonary capillary wedge pressures; this is not done without direct permission from either the Chief Resident or attending physician. In most cases the pulmonary artery diastolic pressure is an accurate representation of the pulmonary capillary wedge pressure. We must always be aware of the possibility of permanently wedged catheters and when this occurs, the resident must free the catheter.

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