|1. It is importrant to monitor the PAP tracing
continuously. (Spontaneous catheter tip migration toward the
periphery of the pulmonary bed may occur.)
|2. Identify patients who are high risk
for PA rupture: women (especially over age 60), history of cardiac
or vascular disease, elevated PA pressures, pulmonary hypertension, anticoagulation
|3. Determine if waveform is dampened vs.
a. check that pressure in the flush bag is at
b.check that flush bag is not empty
c. check for loose connections
d. check for air bubbles present in the system
|3. If spontaneous edge:
a. DO NOT
inflate balloon. Remove syringe to ensure balloon delfates completely.
c.Gently pull back PA catheter 3 cm while securing
d. Maintain sterility of catheter with
the contamination shield (fellow saver)
e. If unable to pull catheter back, notify
|4. If PA catheter remains wedged pul back
an additional 3 cm.
|5. Call MD to notify of wedge catheter.
|6. Monitor patient for pulmonary injury:
a. Hemoptysis: position pt. with
the affected side down (usually the right side) to prevent blood from spilling
inot the unaffected side.
b. Monitor SaO2 continuously
c. MD must reposition catheter to prevent
further injury to lung.