PAC Flashcards
2 indications for PAC monitoring in ICU?
diagnosis of respiratory failure or shock
indications for PAC monitoring in OR?
poor EF, valve disorders, separation from CPB
How do you calculate O2 delivery?
CaO2 x CO
End diastolic volume is?
preload
Calculated measurements from PAC?
PVR, SVR, SV, O2 delivery
Normal value PAP?
25/10
Normal value PAOP?
8-12
Normal value SvO2?
60-75%
Normal CI?
2.5-4 L/min
Normal SVR?
900-1200 dynes/sec/cm5
Normal PVR?
50-140
Normal SV?
50-100 mL
Normal SV index?
25-45
How do you calculate SVR?
[80x (MAP-RAP)/CO]
How do you calculate PVR?
[80 x (meanPAP-LAP)/pulmonary blood flow}
Some relative contraindications to inserting PAC?
large PE, coagulopathy, ventricular ectopy, LBBB, PM, ICD, severe pulmonary artery HTN
BBB complication of PAC?
RBBB
Easier side to float from for an IJ, for a SC?
RIJ; LSC
W femoral PAC placement, you risk what 2 things mainly?
infection and DVT
What is the length to RA, RV, PA, and PAOP if inserting a RIJ?
RA- 15-20; RV-30; PA- 40; PAOP-45-50
When inserting a PAC from the femoral vein, how far is the RA?
40-45
Do you flush and 0 the PAC prior to insertion?
yes
When should you have the catheter sheath in your hand?
before you give up the cordis tray
Once the catheter tip is in the RA, you should do what?
advance the tip w the balloon inflated
How do you withdraw the PAC?
with balloon deflated
With what speed do you advance the PAC in the RV?
quickly
When do you start advancing the catheter tip slowly?
once distal tip is in the PA
Do you want the PAC tip to be in the distal or middle PA?
middle
How is LA pressure measured w a PAC?
When wedging the PAC, blood flow is stopped at that site in the PA and therefore pressure from the LA is transmitted back up to that catheter tip