Are swan-ganz (PAC) still around in your area?

ausrnurse · Apr 7, 2014

Have never seen one in over a year in ICU. We do open hearts, too. It's just gone out of fashion here, and the intensivists all seem pretty happy about it.

KBICU · Apr 7, 2014

Yes we still have them! All fresh hearts get them no matter what, rarely used for anything else.

PRNketamine · Apr 7, 2014

PICU- rarely we see them. In the 2 years I have worked on my unit I have seen 3-4.

MunoRN, RN · Apr 8, 2014

I see them much less, even from the same physicians that used to use them often. Not even all our open hearts come back with one anymore. They just haven't had that much of a role in clinical decision making anymore for many physicians.

ICUPrincessNurse · Apr 10, 2014

All of our CVICU patients have them. Our MICU and SICU (mostly MICU) will get them if they are worried about Pulm HTN. I've floated them in organ donors before when the choice is "float a swan or go to cath lab" to look at numbers for lung transplant.

Tmari1 · Apr 10, 2014

Rarely. We have CVP and ABP lines and use a LIDCO monitor with them. Zero the CVP, enter into monitor, up pop all your numbers. Now, if you're patient is on a ventilator (which almost all of ours are) there are certain values that are inaccurate and can not be used so LIDCO monitors aren't good for every patient. I work in a Burn ICU and use LIDCO mostly for SVR to titrate levo and epi drips so they are accurate. If I need some of the "considered inaccurate" values, then my patient may have/get a PAC. It just depends on the unit/patient. I've only had one patient with one. My patient I had last night had an extensive cardiac history including 19 stents, CABG, CAD, CHF, HTN, DM, Lung Cancer, Acute Renal Failure, Hypothyroidism, etc. and was on vasopressin drip, epi drip, fent, versed, ventilator, and CRRT and his LIDCO monitor was applicable to his condition soo... they are very often useful and less invasive since he already had a left IJ vas cath, left femoral ART line, and right upper arm PICC so we just ran his CVP through the pigtail of his Vas Cath and used LIDCO! And we're talking about a guy who coded 3 times the night before and needed 50mcg epi drip to keep his MAP above 65 and SVR above 400. So, my point is.. LIDCO is taking the place of PAC per patient condition. My patient was in BAD condition and had a LIDCO monitor. (BTW, he was alive when I left so go me for a BUSY night.. especially between the vent, epi drip, and CRRT. Whew.)

ICURNBSN · Apr 12, 2014

I work in CCU and we get them quite often. Mostly for pt. waiting for heart transplants.

nrsang97, BSN, RN · Apr 13, 2014

We use them mostly for donor patients and in the CVICU the most. Recently the ICU I worked in changed over to using the vigileo (connected to an art line and gave a lot of the same numbers). We also used a PICCO which had a art line and central line and it did thermo dilution. PICCO gave a lot of the numbers as the swan.