[JThomas]

I work in an 8 bed ICU.App. once or twice a year we get a patient with a Swan. Needless to say we feel incompetent to deal with this.Any suggestions to help? Do you think we should even have Swans?

[MollyJ]

I think this is an interesting question since it characterizes a lot of technology issues in small to mid size ICU's. I salute the doc that doesn't do more swan lines just to do more. I think this is an issue you have to deal with with your continuing ed department and the doctor that puts them in. When I dealt with Swans (years ago) all I could think of is that someone's lungs could infarct if I didn't correctly interpet that swan pattern. Really though the swan is "just another central line" [saying a mouthful] and much of the care for this is the same. Recognize this as a deficit with your unit manager and cont ed department. Get some good on unit books and resources and maybe a pull out module/video people could watch occasionally on a slow night to keep their awareness and competence high. IN the absence of an actual high patient volume with S-G lines, people will just need continuous opportunities to handle the equipment and the lines and play set up the machine and the line set-up etc.

[hoolahan]

Why not develop a self-Learning booklet to keep on the floor as a reference. Make up a commitee who will do all the research, then put it together with big pictures on every page to illustrate the CONCEPTS. I did one for my unit, but it was focused on interpreting the waveforms, on an advanced level, because in our unit (open heart) almost every patient had a swan. I really learned a lot in the process and was considered the clinical expert for swans after that. There is also a really good CE on line about hemodynamic waveforms, but I don't remember the address. Try a web search. Are you on-line on a computer in the unit? Maybe you could find the site and all the staff could participate in the CE activity. Good Luck.

[This message has been edited by hoolahan (edited December 20, 1999).]