I'm about to start training as an anesthesia tech and all your videos have been so helpful in helping me prepare. just wanted to say thanks for taking the time to do all this, it's much appreciated!
Oh man all I can say is THANK YOU!!!! Very easy to understand! I have one question. Does the catheter itself ALWAYS sit in the PA? and Do you need to back it out to get pressure readings and waveforms for the RA and RV?
Thanks for the compliment! Yes, the distal tip of the catheter always sits in the PA. Remember that hooking a transducer up to the yellow port will give you a pulmonary artery pressure. Clinically, we never need to get a right ventricular pressure. But right atrial pressure and CVP are considered to be roughly equal. In order to know CVP with a Swan, you don't back the catheter up. Rather, there is a port at roughly the 30cm mark of the Swan. This should sit in the right atrium. If you hook a transducer up to this port (blue port), it will tell you the pressure in the RA (CVP). Any other questions? Let me know!
To increase the likelihood of leading the catheter to the PA : 1. Should we Feed the PA catheter through the cordis rapidly or slowly? 2. Should we put the patient upright or supine ?
Can the PCWP be obtained if the PA port was obstructed or not plugged into the machine? I just had an examination that provided a diagram of a PA catheter. It asked what port obtained the PCWP... Answers were as follows: A) CVP port, B) Thermistor port with the red cap, C) PA port, D) the balloon port. I chose C and was told it was wrong. The instructor said it was the balloon port, which is used in the process of getting the PCWP, but it doesn't obtain the PCWP pressure.
That is a horrible question. If that is how the question was worded, the correct answer is the PA port. Prior to wedging, the PA port is sensing blood pressure from the forward moving flow from the pulmonary artery and right side of the heart. Once the catheter is wedged, the PA port can no longer sense blood pressure from the right side of the heart. It can only sense pressure coming from the pulmonary veins and left side of the heart. The balloon allows wedge pressure to be possible, but the port that provides the pressure is still the PA port. Does that make sense?
Pain, I totally understood that and that is why I picked C. I appealed the question and the instructors are watching each other backs and not giving the points back. Thank you for the explanation though.
+linu mathew Thanks for the question! The balloon should definitely only be inflated when the catheter is being advanced. It would need to be inflated if the anesthetist wanted to know what the patient's wedge pressure is.
Thanks a lot for the awesome explanation. But can anybody tell me, how many lumen are there in this catheter ? Since there are 5 ports, so one should be for each, but diagrams of cross section of the catheter on the internet shows only 4 lumen ?. Last one which you did not discuss is the thermistor port or transducer port or are they same thing ? Thank you
I have a question about the cordis with a distal brown port & a white port? The brown port of cordis seems large so therefore can you measure CVP via that port?
@@PainH8er I’m sorry I should have been more detailed… I am referring to the MAC double lumen catheter. Some of my coworkers challenged the fact that the brown distal port may be in accurate due to the diameter
I’m new to the CT-ICU unit in our hospital and your videos are helping me a lot. Thank you!
Thanks for the video. Im going into the ICU soon from ER so I wanna be on top of everything ahead of time
I agree with previous comments. Very easy to understand!!!
I'm about to start training as an anesthesia tech and all your videos have been so helpful in helping me prepare. just wanted to say thanks for taking the time to do all this, it's much appreciated!
Are you still a Anesthesia tech or did you switch it up
Thank you so much for this video. I love how you clearly explained it.
I accidentally put medication in the balloon port
Concise and clear with demonstration, thank you!
Crystal clear explanation , thanks !
THIS IS SOOOOOOO AWESOME. I love the PA catheter. Please do more videos. PLEASE.
great video to get details quickly!!!
thank you so much! such excellent and clear explanation!!!!
Awesome and succinct video! Thank you for making this :)
Thank you so much! Made it so much clearer for me. Going to my ICU clinical tomorrow
Amazing explaination !!
Great video !
great video
Awwweee, thanks!
thanks great video
Awesome thank you
As you are always wonderful.
Oh man all I can say is THANK YOU!!!! Very easy to understand! I have one question. Does the catheter itself ALWAYS sit in the PA? and Do you need to back it out to get pressure readings and waveforms for the RA and RV?
Thanks for the compliment! Yes, the distal tip of the catheter always sits in the PA. Remember that hooking a transducer up to the yellow port will give you a pulmonary artery pressure. Clinically, we never need to get a right ventricular pressure. But right atrial pressure and CVP are considered to be roughly equal. In order to know CVP with a Swan, you don't back the catheter up. Rather, there is a port at roughly the 30cm mark of the Swan. This should sit in the right atrium. If you hook a transducer up to this port (blue port), it will tell you the pressure in the RA (CVP). Any other questions? Let me know!
Thank you, thank you very detail
To increase the likelihood of leading the catheter to the PA :
1. Should we Feed the PA catheter through the cordis rapidly or slowly?
2. Should we put the patient upright or supine ?
1. Slowly
2. We always start supine
Thanks it was very clear to understand.
Can the PCWP be obtained if the PA port was obstructed or not plugged into the machine? I just had an examination that provided a diagram of a PA catheter. It asked what port obtained the PCWP... Answers were as follows: A) CVP port, B) Thermistor port with the red cap, C) PA port, D) the balloon port. I chose C and was told it was wrong. The instructor said it was the balloon port, which is used in the process of getting the PCWP, but it doesn't obtain the PCWP pressure.
That is a horrible question. If that is how the question was worded, the correct answer is the PA port. Prior to wedging, the PA port is sensing blood pressure from the forward moving flow from the pulmonary artery and right side of the heart. Once the catheter is wedged, the PA port can no longer sense blood pressure from the right side of the heart. It can only sense pressure coming from the pulmonary veins and left side of the heart. The balloon allows wedge pressure to be possible, but the port that provides the pressure is still the PA port. Does that make sense?
Pain, I totally understood that and that is why I picked C. I appealed the question and the instructors are watching each other backs and not giving the points back. Thank you for the explanation though.
Why would the Dr change the number on the machine and us a calculator to come up with number . I thought this precedure would give us the number
I have a question, does the baloon at the tip of the catheter remain inflated all the time or only during pressure checks. ?
+linu mathew Thanks for the question! The balloon should definitely only be inflated when the catheter is being advanced. It would need to be inflated if the anesthetist wanted to know what the patient's wedge pressure is.
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Thanks a lot for the awesome explanation. But can anybody tell me, how many lumen are there in this catheter ? Since there are 5 ports, so one should be for each, but diagrams of cross section of the catheter on the internet shows only 4 lumen ?. Last one which you did not discuss is the thermistor port or transducer port or are they same thing ? Thank you
Yes, I didn't mention the thermistor port. Mostly because we never use it in anesthesia. Thanks for pointing that out :)
How many lumen are there in this catheter ? Thank you
4 ports. 3 transducer ports plus one balloon port. Some Swans also have a thermistor.
I have a question about the cordis with a distal brown port & a white port? The brown port of cordis seems large so therefore can you measure CVP via that port?
I haven't seen a Cordis with a distal brown port. I'm not saying they don't exist; I just haven't seen one yet. Sorry I can't answer your question!
@@PainH8er I’m sorry I should have been more detailed… I am referring to the MAC double lumen catheter. Some of my coworkers challenged the fact that the brown distal port may be in accurate due to the diameter
aren't there 5 ports? is the fifth one the thermistor port?
You are right! I should have talked about that, but we just never use it. :/
PainH8er thanks a ton.. this helped a lot. :)
Thank u
Good
Contamination shield? I just call it the swandom. Don't be a fool and wrap that tool! xD
Guest Console ur funny haha
My preceptor calls the shield a “swandom”
Some segments in the video are stamped not adjacent to each other