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What would you add to this must-do list for new ICU nurses managing pulmonary artery catheters (aka Swan Ganz catheters)? There are five crucial MUST-DOS I tell every nurse who cares for a Swan: 🌊 You must understand ALL waveforms. When a PAC is properly positioned, you will see two continuous waveforms: the right atrial (RAP/CVP) & the pulmonary artery (PAP). Two other waveforms can be obtained with PAC use: RV & pulmonary artery occlusion pressure (PAOP/"wedge"). PACs can migrate from the proper position - even when it is locked at the same CM mark! 🔐 You must know WHERE the PAC is locked. This should be part of your routine assessment, bedside shift report, or handoff report from the cath lab/OR. Note the CM marking and ensure it is locked on the introducer - if it has a locking component 🫠 ❤️ You must know NORMAL intra-cardiac & hemodynamic values. Obtaining this information is the easy part. Interpreting that data is the next step. You have to know what "normal" is, including what is "normal" for your patient. Remember: it takes time to understand the application of this information. My knowledge is STILL growing, and I have worked with PACs for > 15 yrs. 🎈You must ensure the BALLOON is deflated with regular monitoring. Each facility has its method of how to maintain the inflation syringe: Empty unlocked vs. locked, unattached, ect... Know your units protocol. Either way, make sure the balloon is deflated. Remember, this is a passive process. Actively pulling back on the inflation syringe can lead to balloon rupture. This also aligns with Number 1. ⚠️ You must know the COMPLICATIONS of PAC use. PACs are an invasive way to monitor hemodynamics and come with unique complications. Ranging from infection risk to pulmonary infarct. It is important to understand risks & how to mitigate, recognize, and manage them. 🧠 Looking for to increase your knowledge on Swan catheters? Check out our Hemodynamics resource in the shop! #icunursing #ccrnreview #cvicu #newgradicunurse
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