NS for CO

[Cleveland-RN]

At my facility, we use D5W for our cardiac output thermistor readings. I recently had an order to make all of our gtts NS for low NA levels. Why couldn't we change this to NS? No one at my facility can tell me why, just that you can't do it b/c it's harmful.

[dorimar, BSN, RN]

we always use NS for out COs

[Dinith88]

At my facility, we use D5W for our cardiac output thermistor readings. I recently had an order to make all of our gtts NS for low NA levels. Why couldn't we change this to NS? No one at my facility can tell me why, just that you can't do it b/c it's harmful.

Where i work, when we shoot them we use saline....HOWEVER, we dont shoot them any more. We use continuous output/index monitors that plug right into the swan. All of our swans are compatible with these machines...makes it so much easier. I thought it was pretty commonplace?????

[dfk, RN, CRNA]

At my facility, we use D5W for our cardiac output thermistor readings. I recently had an order to make all of our gtts NS for low NA levels. Why couldn't we change this to NS? No one at my facility can tell me why, just that you can't do it b/c it's harmful.

cleveland, i don't understand the 'harmful' issue.. in general, fluids are fluids.. (please don't comment on the hypo/hyper/neuro/blah blah blah stuff, b/c i know) - if it is the low sodium level, in general, restrict fluids, perhaps give slow normal saline infusion and continuously monitor sodium levels.. hypertonic tx is fading out.. the 'all gtts in sodium' are a fair tx plan.. again, can't make me agree as to the reason why not using normal saline for CO.. what type of facility are u at if i may ask? who's making the decisions/protocols (if this is one) ?

[grambograham]

We use NS for our Swan.

[oldiebutgoodie, RN]

At my facility, we use D5W for our cardiac output thermistor readings. I recently had an order to make all of our gtts NS for low NA levels. Why couldn't we change this to NS? No one at my facility can tell me why, just that you can't do it b/c it's harmful.

We had this discussion where I work, and I looked it up in the AACN procedures manual. Apparently, D5W and NS have different specific gravities, and the monitors are calibrated to the specific gravity of D5W. If NS saline is used, the CO may be 2-3% lower than with D5w. (Please double check the manual to confirm).

Oldie but goodie

[TennRN2004]

Where i work, when we shoot them we use saline....HOWEVER, we dont shoot them any more. We use continuous output/index monitors that plug right into the swan. All of our swans are compatible with these machines...makes it so much easier. I thought it was pretty commonplace?????

We have the vigilence monitors which can be connected to a swan for continuous CO/CI, but to my knowledge, we only use the vigilence in septic patients and we have never used the continuous CI/CO function. Our docs don't put that many swans in anymore, the only ones who come in swaned are the post op hearts/AAAs. We typically have their swans out within 12-18 hours, so I don't think our OR sees a need to have the continous monitors.

P.S.-To the OP we use NS for our CO flushes.