PA lines

Question 1

purpose of PA line

Answer 1

direct assess of R heart function

indirect of L heart fnctn

Question 2

indications

Answer 2

• assess CVs and response to therapy, pulm status and response, fluid requirements
• monitor of a PT with multi system failure

Question 3

what is connected to the proximal port

Answer 3

Transduced CVP
RAP

R side preload

blue

• there is also a syringe for CO attached to blue CVP lumen

Question 4

what is attached to the distal port

color?

Answer 4

the transducer for the PA- will read the pressures

yellow

Question 5

what is a cortis

how do you measure

Answer 5

line that is introduced into vein

find the thick black line closest to the top of cordis, that is 50cm. every other small line is 10 cm

• *measure from top of cordis to first black line, subtract measurement from black lines and measurement to hub
  ex. 50 - 8 = 42 cm
• have TKVO running all the time

Question 6

what is the significance of PAD and PCWP being 1-4 apart

Answer 6

then you can use the number taken from the PAD without having to inflate the balloon for that shift

Question 7

only use the PAD for L sided Preload if….

Answer 7

1. the PAD is normal
2. if the wedge and PAD are within 1-4 of each other
3. if there is no lung pathology

Question 8

complications of PA insertion

Answer 8

• dysrhythmias
• pneumothorax
• balloon rupture
• ischemia/infarction
• artery rupture
• infection
• knotting

Question 9

when to obtain a hemodynamic profile?

Answer 9

• baseline
• aid in diagnosis
• following any sudden change
• assess specific intervention
  med titration, vnet changes, add/dc meds, volume/diuretics
• ongoing trending

Question 10

wedging the PA *****

Answer 10

• level/zero/ PT position
• assess waveform,
• 1.5cc air in balloon, inject SLOWLY
• watch wave
• inflate balloon with the minimal air needed to obtain PCWP wave
• hold 3 resp cycles or max 15 sec
• read PCWP at end-expiration
• allow balloon to deflate passively

Question 11

cardiac outputs

Answer 11

• inject D5W or NS
• usually 10cc through proximal port
• fast and steady no longer 4 sec
• min of 3 CO’s within 10% of each other
• average values

Question 12

if CO and CI are on the low side

Answer 12

then a good indicator of contractility

not if these numbers are on the high side

Question 13

when is the ERO2 increased

Answer 13

then there is increased demand

Question 14

if ERO2 is high what is SvO2

when are the possibly normal?

Answer 14

decreased. ERO2 high from demand and SvO2 lower from more being consumed

both could be normal (60-80 and 25-35) in sepsis

Question 15

who removes the PA line?

Answer 15

MD

Question 16

what cant you do with the distal port? what can you do?

Answer 16

dont infuse here

do- only retrieve SvO2 sample from here