![]() ![]() Pulmonary artery systolic pressure (PASP) is the pressure exerted by the right ventricle (RV) during systole on the PA. PAP is a reflection of cardiac heart pressures and is read as a systolic and diastolic number. CI is merely CO with consideration of the patient’s body surface area (BSA), and is, therefore, more accurate for clinical decision making. The only lab values needed to run a Fick is a mixed venous saturation (SvO2) and an arterial saturation. All of these numbers are collected and inserted into a Fick calculator which gives us CO and cardiac index (CI). With a PAC, CO is determined by obtaining an SvO2 level, the patient’s body surface area, a hemoglobin level, and an SpO2 reading. CO is the amount of blood pumped by the heart each minute and is simply heart rate multiplied by stroke volume (the amount of blood ejected with each beat). As a stopgap you could switch the pressor infusion to the distal port, get your x-ray, and think about getting the line replaced.PACs allow for assessment of Cardiac Output (CO), Pulmonary Artery Pressure (PAP), Mixed venous oxygenation (SvO2), Pulmonary Artery Wedge Pressure (PAWP), and Central Venous Pressure (CVP) through blood draws and waveform analysis. If you were infusing pressors through the proximal port - perfectly OK in a properly situated line - and those pressors now began infusing into the tissue on account of the port was pulled back out of the vessel - that would be a bad thing. Suppose you turned your patient over and the line took a yank, got pulled out a couple of inches. Doesn't ring no bell.Īn important point: don't run anything into a central line lumen without checking that there's a good, visible blood return. I never heard of TPN "burning" anyones vasculature in relation the port chosen - I been hanging TPN for a long time, too. Make sense? We use them for intermittent med infusions like antibiotics, etc., never for pressor/vasoactive drips.īlue and white ports can be used at your preference. ![]() Next: you wanna use the brown port for your CVP transducer, on account of it's the largest lumen, also it's looking straight down into the RA. ![]() The blue one is medial, the white one is proximal - closest to the site of insertion. So the port that opens up at the tippy end of the line - which is the brown-ended one on an Arrow multilumen - that's the distal port. The ports are described in relation to the insertion site - where the line enters the patient. Like, normally, the fingers are distal to the elbow, right? Further away from the center of the body? Hope this helps! But, most likely, you will never forget which port is used for what after getting questioned in clinicals!įirst concept is that with regards to the position of the ports, the normal idea of distal and proximal is reversed. Also used for blood draws and monitoring central venous pressure (CVP). Medications, IV solutions, lipids, and colloids. ![]() Medications, IV solutions, more viscous fluids like TPN and lipids, colloids, and blood products if distal lumen is not open. Medications, IV solutions, and blood products if other lumens are not open. This may vary by manufacturer, but typically each lumen of the catheter is a different color, its own separate line, and used for designated purposes. When I worked in the ICU, patients were often receiving multiple medications and fluids at once, so a triple lumen central catheter, and knowing the function of each port, was essential. It's important for nurses to understand the lumen configuration and designation when caring for a patient with a triple lumen. ![]()
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