Advanced Hemodynamics - Orlando Health

PAC Insertion
Advanced Hemodynamic Monitoring
Preparation for Catheter Insertion
The nurse should:
Explain the procedure to family or patient
Ensure that all the necessary consents are signed
Have emergency equipment available
Gather all the equipment for line setup and PAC insertion per institutional guidelines.
Prepare a sterile field
Depending on the contents of the catheter insertion tray, gather additional 4 x 4 gauze,
sterile towels, and a sterile gown
Obtain syringes with 10 ml saline flush solution
Flush all ports along with any attached stopcocks, using sterile technique.
Cover the prepared tray with sterile towels
The physician will use sterile technique to insert the PAC. This is done using either a percutaneous
or a cutdown approach. Once inserted, the catheter is progressed and the balloon is inflated. The
catheter then ‘floats’ with the flow of the blood from the right atrium to the right ventricle through
the pulmonic valve in the pulmonary artery. Observation of the waveforms as the catheter advances
identifies the location of the catheter.
The distal tip of the PAC once completely inserted will rest in the pulmonary artery, where it will
continuously measure the pressures from the right side of the heart (CVP) and the lungs (Pulmonar
artery systolic and pulmonary artery diastolic).
Post-Insertion
Once the PAC is properly in place, the practitioner will suture it in place, and the nurse will perform
the following activities:
Place a sterile clear occlusive dressing over the site
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