Continuous arterial ABG monitoring

[General E. Speaking, RN, RN]

Have any experience with these machines? We have one CV surgeon that likes to use them. He doesn't do as many surgeries as the other docs so we don't see it used regularly. My pt had one the other day. 2nd day CABG post op. I believe it was called a VIA- was set to draw blood every hour to read electrolytes, ABGs and H/H.

The charge nurse was available to help me troubleshoot it a couple of times. We were so busy, I really wanted time to sit down and investigate it. It is housed in CVOR and the patients come to us with it connected.

My goal is to find the manual/policy and investigate further on a day that isn't so crazy. I tried to do an internet search after I got home but didn't get much info.

How common are these types of machines and do you use them regularly?

Thanks!

[Biffbradford]

Sounds expensive. Is that really more practical than just drawing up a sample from the art line and running it through the 'stat' machine? (I forget what those are called). Those perfusion machines (like ECMO) have continuous ABG meters on 'em, but I don't think they do 'lytes and 'crit.

[Da_Milk_of_Amnesia, MSN]

Sounds expensive. Is that really more practical than just drawing up a sample from the art line and running it through the 'stat' machine? (I forget what those are called). Those perfusion machines (like ECMO) have continuous ABG meters on 'em, but I don't think they do 'lytes and 'crit.

The machine you are refering to is called an "I-Stat" machine.

[General E. Speaking, RN, RN]

Sounds expensive. Is that really more practical than just drawing up a sample from the art line and running it through the 'stat' machine? (I forget what those are called). Those perfusion machines (like ECMO) have continuous ABG meters on 'em, but I don't think they do 'lytes and 'crit.

No, it doesn't seem practical to me but this is what he likes to use.

[Biffbradford]

Ka-ching! $$$! (really)

[General E. Speaking, RN, RN]

It's only one of our CV surgeons that uses it and I heard today that it has to set up by the company representative every time it is used. So, someone from that company comes in for each set up. Cha CHING $$

I am having a hard time getting my hands on a manual. Even if we are not allowed to set it up, we are still responsible for monitoring it and mixing/changing the "flush bag" which has heparin (and another med additive that I cannot recall at the moment).

Nobody else has had experience with this kind of equipment?

[3ccBolus]

That sounds ludicrously unnecessary. Has the surgeon ever provided a rationale for this? A gas on a sedated and ventilated patient isn't going to change that dramatically very quickly. You can look at a newly extubated patient's condition and guess what their gas will look like, and draw it if/when needed. A crit shouldn't drop real quick, and if it does you should see other indicators about what's going on with the patient (chest tubes, hypotensive, tachycardic, low filling pressures etc). A machine that does this automatically, and checks some things q hour is a really unnecessary cost in my mind!

[in2bate71, BSN, RN]

Does he have a vested interest in Via Medical, perhaps?

[NicuGal, MSN, RN]

We used those in our unit for several years. We had troubles with it, a lot. You have to send samples to the lab to see if they are close and we were having a lot of issues with the electrolyte part of it. We also had a lot of line sepsis from it, but we use our lines probably longer than an adult does. Once we got rid of the VIA's and went to BioSensor our line sepsis fell dramatically.

And it does not have to be a company rep to set it up. Our RT's set ours up. They are selling you a line, that is for sure! And I believe the kits are only good for X amount of time and they are expensive, so make sure it is a charge item!

The fluid for the line can just be whatever you put thru your regular Artlines, it doesn't have to be anything special. The waste bag is gross and I hated to change those out.

Good luck with it...we got rid of ours due to increased sepsis and the cost.

[General E. Speaking, RN, RN]

Thanks for the replies. I agree it seems like a ridiculous expense. I wonder, too, if the doc has some sort of "interest" in the company supplying them.

[WSU_Ally_RN, BSN, RN]

I'm in a PICU and we use them all the time to monitor our little kiddo's. The amount of blood they use is very little, less than we would be wasting and sending to the lab for our ABG's and in the little little guys, every drop we save counts.

Depending on how sick they are, we do VIA's hourly or q4 hours. It's nice to see trends hourly in the really sick one's and are able to make vent changes, or replace lytes pretty quick.

[WSU_Ally_RN, BSN, RN]

sorry, somehow i double posted!