74: Pulmonary Artery Catheter Removal

PROCEDURE 74


Pulmonary Artery Catheter Removal




PURPOSE: 


The pulmonary artery catheter is removed when the patient’s condition is improved sufficiently that hemodynamic monitoring is no longer necessary, when there is risk for complications from the presence of the catheter (e.g., dysrhythmias, pseudoaneurysm), or when there is risk for infection associated with the prolonged use of intravascular catheters.



PREREQUISITE NURSING KNOWLEDGE




• Knowledge of the normal cardiovascular anatomy and physiology is necessary.


• Knowledge of normal values for intracardiac pressures is important.


• Knowledge of normal coagulation values is needed.


• Knowledge of normal waveform configurations for right atrial pressure (RAP), right ventricular pressure (RVP), pulmonary artery pressure (PAP), and pulmonary artery occlusive pressure (PAOP) is necessary.


• Venous access routes should be known.


• Principles of aseptic technique should be known.


• Advanced cardiac life support knowledge and skills are needed.


• Potential complications associated with removal of the pulmonary artery (PA) catheter should be understood.


• Clinical and technical competence in PA catheter removal is necessary.


• Knowledge of the state nurse practice act is important because some states do not allow this intervention to be performed by a registered nurse.


• Air embolism can occur during the removal of the catheter. Air embolism after the removal of the catheter is a result of air drawn in along the subcutaneous tract and into the vein. During inspiration, negative intrathoracic pressure is transmitted to the central veins. Any opening external to the body to one of these veins may result in aspiration of air into the central venous system. The pathologic effects depend on the volume and rate of air aspirated.


• Indications for the removal of the PA catheter include the following:



• Contraindications to percutaneous removal of the PA catheter include the following:




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Jun 4, 2016 | Posted by in CRITICAL CARE | Comments Off on 74: Pulmonary Artery Catheter Removal

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