CCN
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Crit Care Nurse 2002 Apr; 22(2): 132
This Article
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Simpson, L.
Right arrow Articles by Schatz, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Simpson, L.
Right arrow Articles by Schatz, K.

Ask the Experts
Do you have a clinical, practical, or legal question you’d like to have answered? Send it to us and we’ll pass it on to our "Ask the Experts" panel. Call (800) 394-5995, ext 8839, to leave your message. Questions may also be faxed to (949) 362-2049, mailed to Ask the Experts, CRITICAL CARE NURSE, 101 Columbia, Aliso Viejo, CA 92656, or sent by e-mail to ccn{at}aacn.org. Questions of greatest general interest will be answered in this department each issue.

Linda Simpson is Manager of Clinical Programs at Edwards Lifesciences LLC, Irvine, Calif.

Katie Schatz is a clinical practice specialist for the American Association of Critical-Care Nurses, Aliso Viejo, Calif.

Q When obtaining a wedge pressure, how will I know that the balloon is deflated if I don’t withdraw the air from the balloon with the syringe?

A Linda Simpson, RN, MSN, and Katie Schatz, RN, MSN, NP-C, reply: ______

First, it is necessary to discuss the proper way to obtain a wedge pressure. According to the AACN Procedure Manual for Critical Care,1 the patient should be placed in the supine position with the head of the bed between 0 and 45 degrees. The pulmonary artery (PA) wedge pressure can easily be obtained by inflating the pulmonary artery balloon port, slowly, with enough air to change the PA waveform, to a PA wedge waveform. Use no more than 1.5 mL of air. Keep the balloon inflated for 2 or 3 respiratory cycles, but usually no more than 10 to 15 seconds. During this time, run a dual-channel strip; this strip should include both an electrocardiographic waveform as well as the PA waveform. This step is important to help identify the effect of ventilation on the wedge pressure. After the wedge pressure is obtained, the syringe is disconnected. When the syringe is removed, the return of the PA waveform demonstrates that the balloon has deflated.

Using the syringe plunger to withdraw air from the balloon can lead to potential damage to the balloon as the balloon is withdrawn into the lumen. The pressure required from the balloon to overcome the resistance from the syringe pressure can vary and may not be sufficient to allow for complete balloon deflation. Therefore, the balloon may still be slightly inflated even though there is a pulmonary artery waveform on the monitor. Allowing for passive deflation of the balloon by removing the syringe is the recommended practice.

Before reattaching the syringe to the balloon port, be sure that the syringe plunger is pushed in completely to allow any residual air to escpate. Then, simply reat-tach the syringe to the balloon port, leaving the gate-valve open to allow for any further deflation. For more information on the proper way to obtain a PA reading or wedge pressure, please see the AACN Procedure Manual for Critical Care.

Reference

  1. Lynn-McHale DJ, Carlson KK, eds. AACN Procedure Manual for Critical Care. 4th ed. WB Saunders Company; 2001.




This Article
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Simpson, L.
Right arrow Articles by Schatz, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Simpson, L.
Right arrow Articles by Schatz, K.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS