[Burnt2]

I guess research shows there is no improved outcomes if a doctor pops in a swan vs leaving it out


too bad.....it's the best way to familiarize oneself with heart function/heart pressures

it's also a good chunk of the CCRN test


mebbe I should transfer to CTCU

[BBFRN]

Is this from an article you read? If so, can you provide a link?

Thanks!

[Burnt2]

No I don't have a link, a few docs were talking about it one night; I guess one of them assisted with the research (which was done at cleveland clinic I think).

Basically they said that there are no differences in patient outcome - regardless if a swan is used.

Also, we just don't use them that much in our unit (CCU) anymore - use has tapered down over the last couple years. CTCU, where I float, uses them for the post op CABG pts, but they pop them out pretty early if the patient is stable.

edit: just did a quick search and found a few hits on my schools online journal center; can't link them though (password restricted). Apparently it's a debate thats been going on for a decade or so, but now the studies are starting to trend that way.

[meandragonbrett]

Studies have to be taken with a grain of salt. I think the most recent published study showed that there is not difference in mortality between those who were swaned and those who weren't swaned. Also, there is a non-invasive way to monitor CO/CI and all of the other swan numbers.

Swans are very useful if you're using dobutamine. You don't see a lot of swans outside of the CVICU as those patients are generally just not as hemodynamically unstable.

[Burnt2]

Yea you're right, its good to have with dobutamine. I've never used the noninvasive methods, but they sound really interesting.

We won't get a taste of that stuff though until a hospital executive has an MI and spends the night surrounded by our decades old equipment.

There was a time when it seemed like everyone in our unit from the doctors down to patients with the sniffles had a swan hanging out of their neck

[BBFRN]

Originally Posted by Burnt2

No I don't have a link, a few docs were talking about it one night; I guess one of them assisted with the research (which was done at cleveland clinic I think).

Basically they said that there are no differences in patient outcome - regardless if a swan is used.

Also, we just don't use them that much in our unit (CCU) anymore - use has tapered down over the last couple years. CTCU, where I float, uses them for the post op CABG pts, but they pop them out pretty early if the patient is stable.

edit: just did a quick search and found a few hits on my schools online journal center; can't link them though (password restricted). Apparently it's a debate thats been going on for a decade or so, but now the studies are starting to trend that way.

Thanks, Burnt2- I'll try to find them in my school's database, too.

I also work CCU/OHU. I initially thought you meant that they weren't using them on fresh hearts, either. We d/c ours pretty early on stable hearts as well.

[dianah]

My understanding of this is that swans left in for days for monitoring (non-emergently) increases the risk of infection (a great colonization site!).

Also, with new advances in echocardiography (hardware and software), pts may be monitored NON-invasively, with the same outcomes and without the infection risks.

The downside, as pointed out, is decreased RN exposure to their use and possibly decreased knowledge and skill in their "care and feeding."