Hemodynamic monitoring

1. +
Hemodynamic
Monitoring
Randi Weinzierl

2. +
Survey results
 Rate your knowledge of an Art(arterial) Line.
 Rate your knowledge of CVP (central venous pressure) monitoring.
 Rate your knowledge of a Swan-Ganz catheter.

3. +
Survey results
 I have had HANDS ON experience with hemodynamic
monitoring such as an Art line, CVP, or Swan-Ganz catheter.

4. +
Survey Results
 I can recognize the significance for using hemodynamic monitoring
techniques such as an Art line, CVP monitoring, and Swan-Ganz
catheter.

5. +
Survey Results
 I have full understanding of where Art lines, CVP monitoring, and
Swan-Ganz catheters are placed in the human body.

6. +
Survey Results
 I would benefit from a visual teaching tool that outlined the
main points, care for, waveforms, and locations of Art lines,
CVP, and Swan-Ganz catheters.

7. +
Objective
Create a visual teaching tool which outlines
the significance, placements, and waveforms
of hemodynamic monitoring techniques
giving students the opportunity for hands on
learning.

8. +
Arterial Line
 Continuously monitor systemic blood pressure
 Indications:
 Hemodynamic instability
 Vasopressor requirement
 Frequent ABGs
 Most common locations:
 Radial, femoral, axillary, dorsalis pedis

9. +
Arterial Line Placement

10. +
Arterial Line Waveform

11. +
Arterial Line Waveform

12. +
Central Venous Pressure Monitoring
 Direct measurement of the blood
pressure in the right atrium and
vena cava
 Indication:
 Assess right ventricular function
 Systemic fluid status
 Rapid infusions
 Infusion of hypertonic solutions and meds that can damage veins
 Serial venous blood assessment
 Common locations
 Internal jugular, subclavian vein, femoral vein
 The tip of the catheter rests in the lower third of the superior vena cava

13. +
Central Venous Pressure Monitoring
 Normal CVP: 2-6 mm Hg
 CVP is elevated by:
 Overhydration (increase in venous return)
 Heart failure or pulmonary artery stenosis (limit outflow and lead to
venous congestion)
 CVP decreases with:
 Hypovolemic shock (from hemorrhage, fluid shift, dehydration)

14. +
Central Venous Pressure Monitoring

15. +
Central Venous Pressure Monitoring

16. +
Central Venous Pressure Waveform

17. +
Central Venous Pressure Waveform

18. +
Swan-Ganz Catheter/Pulmonary
Artery Catheter
 Provides diagnostic information to rapidly determine hemodynamic
pressures, cardiac output, and blood sampling for mixed venous
oxygen saturation
 Measures
 CVP, PAP, cardiac OP
 Indications: Diagnosis vs. Therapy
 Post MI
 Cardiac Surgery/Major surgery
 Resuscitation
 Shock
 Pulmonary Edema
 Oxygen transport: ventilation and perfusion

19. + Swan-Ganz Catheter/Pulmonary
Artery Catheter

20. +
Swan-Ganz/PAC Placement &
Waveform

21. +
Swan-Ganz/PAC Placement &
Waveform

22. +
Exit Survey
https://www.surveymonkey.com/s/G3
C6ZNT

23. +
References
 Goldberg, J. (n.d.) Fundamentals of critical care:
Hemodynamics, monitoring, shock. Retrieved from:
http://www.ucdenver.edu/academics/colleges/medicalschool/de
partments/surgery/education/GrandRounds/Documents/GRpdf
s/2010%20-%202011/Aug%209%20Shock-Hemodynamics-
Monitoring%20Goldberg.pdf
 Kuhn, C., & Werdan, K. (2001). Surgical Treatment: Evidence-based
and problem-oriented. Retrieved from:
http://www.ncbi.nlm.nih.gov/books/NBK6895/
 Posey, A. (2009). Hemodynamics: Basics. Retrieved from:
http://www.rnceus.com/course_frame.asp?exam_id=46&directo
ry=hemo