PAWP

  1. 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 still commonplace elsewhere. Our CT surgeons go by PAD, CI, and CVP.
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  2. 26 Comments

  3. by   cabgnurse
    We don't wedge either. Our surgeons have some "notify me" orders regarding our PA pressures but they're really in love with CI.
  4. by   Esme12
    It falls in and out of favor. It also varies widely facility to facility and state to state.
  5. by   Lovelymo79
    Mine wedge when they first place the Swan but after that, I never hear anyone mention it again.
  6. by   Dodongo
    It depends on the physician who puts the orders in. I've had some MDs that order the wedge once a shift and some that want it only sometimes and they'll ask for it. But, yes, we do wedge in my ICU. But swans in general aren't put in that often and they are taken out ASAP.
  7. by   applewhitern
    We do all the time. We have one doctor in particular who just LOVES swans, and it seems every one of his patient's get one, whether they need it or not. I have read that a lot of places aren't using swans nearly as much as they used to, but our ICU's still do.
  8. by   ghillbert
    Only when they go to cath lab for a RHC. Not in the ICU.
  9. by   Sha-Sha RN
    My ICU does wedge. It depends on the pt and their fluid status.
  10. by   RN-LOGIC
    The usage of a WEDGE is dependable in the patient's situation and knowledge of the provider or nurse. It should not be use for every patient.
  11. by   StayLost
    Yes, but it depends on the physician. It's common for our transplant docs to ask us for daily wedge.
  12. by   Bronx1560
    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.
  13. by   StayLost
    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.
  14. by   pitt81
    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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