[armynurse]

Would like to know the transport policy for various ICU's for patients with SWAN-GANZ lines. Let's say you have a patient with a SWAN and you need to go down for a CT scan and your portable equipment does NOT allow PAP monitoring. Are you allowed to take the patient? It seems risky since you wouldn't know if the catheter inadvertantly occluded the pulmonary artery.

Thanks,
Chris

[begalli]

We disconnect everything from the swan that can be disconnected (pap, cvp, temp and co cables).

Basically, anything that absolutely does not need to travel, doesn't.

[heartICU]

We take everything. Our monitors allow for PA monitoring, though. We usually take lines out when we are done with them though - i.e. if the patient doesn't need the swan, we would have Dc'd it already. If it is still there, we use it for monitoring.

[UCDSICURN]

We're able to monitor 2 pressure lines with our transport monitors. We disconnect the cables from our CCO machine but leave everything else as is. At my other facility where I worked we noted the depth of the swan, made sure it was very secure to the patient. Getting strips before and after transport is probably a good CYA move also.

D.C.

[apaisRN]

I really hate transporting pts with a-lines, since we just have crappy cardiac monitors that weigh a ton. If the a-line pulled out or was disconnected I would have no idea until the blood starting pouring off the bed. Same with swans but we don't handle those so much and they tend to be the cardiology pts who don't travel as much as the sick medicals.

[nurse-lou]

Originally Posted by heartICU

We take everything. Our monitors allow for PA monitoring, though. We usually take lines out when we are done with them though - i.e. if the patient doesn't need the swan, we would have Dc'd it already. If it is still there, we use it for monitoring.

Ditto!

[11:11]

Originally Posted by UCDSICURN

...we noted the depth of the swan, made sure it was very secure to the patient. Getting strips before and after transport is probably a good CYA move also.

D.C.

Exactly!

Where I work we transport pt's with swans all the time and have to go down four floors to do it.

I note the depth, run strips after, and chart the same. Also write a quick note-

11

[Elenaster]

Our P&P states that we must provide the same level of care and monitoring that the pt. would receive in the unit during transport. Transporting with the SWAN, EVD, etc. is a pain, but if the patient is sick enough to need a SWAN (we don't use them unless they're very, very ill - i.e. knocking on death's door), it's probably best to take it with you anyway in case they C-O-D-E in the scanner.

[heart queen]

Originally Posted by heartICU

We take everything. Our monitors allow for PA monitoring, though. We usually take lines out when we are done with them though - i.e. if the patient doesn't need the swan, we would have Dc'd it already. If it is still there, we use it for monitoring.

As previously mentioned we do disconnect the CCO or thermodilution CO. Running strips pre and post transport are included in our policy. Just tape the transducers to the outside arm and put the pressure bag and tubbing in the bed. After you do this so many times, it only takes 5 minutes to untangle, reconnect, level and zero. If your're not monitoring your PA, and the pt. goes into VT, how can you assess the placement of the catheter to ensure it's not now RV? Worse yet, returning and finding a permanent wedge.....Which is why I keep it all taped to the arm, and in the bed with the patient.

[KimberRN1]

We disconnect everything... I usually lay the bag and the lines on the bed...then pull the cables out of the monitor...that way when you get back you just plug the cables back in.....Why didn't hospital designers put the ICUs by CT anyway?...lol....don't they know it's a huge production to transport?