PAWP - page 2

Just curious, do very many facilities wedge anymore? I know this topic has been posted before, but it looks like the threads are several years old. We don't personally wedge at my hospital, but I'm curious as to whether it is... Read More

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    wedge is a no no with fresh hearts in my facility. We aren't risking busting the artery or valve when PAD is close enough to wedge. Besides in combination with your other hemodynamic you can tell if the issue is (cardio or pulmonary). We are old school as well swan is preferred method for open hearts (CT surgeon). However we are also using The Vigileo monitor for our CHFers/septic pts. but i have issues with it cause you need a working a line for my #'s to be write. We wedge pts only if the don't have any cardiac surgery PRN &'its usually cardiology who like this they swear by it but we all know wedging is going away cause of the risks.
    Biffbradford likes this.

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    A little off topic, but want to throw in there that I find the Vigileo useless. The first time I encountered it was when I worked as an Organ Recovery Coordinator & I quickly learned that it was unreliable. I've even had dead, pulseless patients with cardiac numbers.
    LNRN11 likes this.
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    In my CICU in seems that every chf pt we get has a swan and we get number q6h along with a wedge i
    always wonderd if that is outdated or just a different way to practice.
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    My hospital wedges...
    Esme12 likes this.
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    Completely agree w/ you, StayLost! We rarely use them because of the discrepancies. I had one a few months ago and my CT surgeon had me hook up a CO/CI injectate syringe and shoot an index. It was way off.
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    Haven't seen a wedge pressure used in years. In fact, most post op heart orders state: "do NOT wedge".
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    Wedging a PA catheter requires a degree of nursing skill that most nurses don't want to bother with. You have to know the waveforms and where in the EKG and respiratory cycle to measure, preferably after you have graphed the waveform on paper. It's usefull information but you have to know how to safely obtain it. Properly done it is an extremely safe thing to do. And even if you don't wedge you should know what the wave form looks like in case the catheter accidently advances to wedge.
    applewhitern and Esme12 like this.
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    At my hospital we do not wedge because we lost a patient years ago due to this. Like many who have said before the EV 1000 monitor is standard at my facility.
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    We can wedge in theory, but usually just use all the other swan numbers and waveforms. I've only seen a wedge once in our ICU, and it was a medical patient.
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    Esme12 likes this.

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