Chapter 4
| Monitoring
©2007-2015 Physio-Control, Inc.
LIFEPAK 15 Monitor/Defibrillator Operating Instructions
101
OBSERVATION
POSSIBLE CAUSE
CORRECTIVE ACTION
Invasive BP higher than cuff BP
Transducer level lower than
the heart
•
Reposition transducer to
correct height.
Improper zero reference
•
Rezero.
Catheter whip artifact
•
Change catheter tip position.
•
Use mean pressure values
(mean pressure is less
affected by extremes and will
therefore reflect a more
accurate reading).
Inability to flush system
Pressure bag leaking
•
Keep positive pressure in flush
bag at all times.
•
Remove dressing to check for
external kinking.
Partially kinked or
obstructed catheter
•
Replace catheter, if clotted.
Inability to zero system
Stopcock not open to air or
defective
•
Check stopcock position.
Replace any defective
stopcocks.
Defective transducer
•
Replace transducer.
System has been zeroed but
continues to indicate zero
reference required
Steps to zero system
performed in wrong order
•
Close stopcock to air before
placing cap on port.
Catheter whip (fling) artifact
Pulmonary Artery
Excessive catheter
movement. Motion of the
catheter tip within the vessel
accelerates fluid movement
in the catheter, causing
artifact to be superimposed
on the pressure wave,
increasing readings by 10–
20 mmHg.
•
Change catheter tip position.
•
Use mean pressure values
(mean pressure is less
affected by extremes and
therefore reflects a more
accurate reading).
Permanent Pulmonary Wedge
Pressure (PWP) tracing
(wedge tracing persists after
balloon deflation)
Catheter tip partially clotted
•
Use syringe to aspirate, and
then flush.
Catheter migrated distally in
pulmonary artery
•
Observe PA waveform before
balloon inflation. Flattening of
the waveform could indicate
wedging with balloon deflated.
Turn patient side to side in
Trendelenburg position, or
stimulate cough in attempt to
dislodge catheter.
•
Retract catheter with balloon
deflated until proper position
is obtained.
•
Minimize chances of catheter
advancement by firmly
anchoring catheter at insertion
site.
Содержание LIFEPAK 15
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