Page 217 - 2026 SMOG

INVASIVE PRESSURE MONITORING
Purpose
• MEDEVAC Crews are required to monitor invasive pressure on any patient with central venous
or arterial access
Procedure
• If the referring facility’s transducer unit is not compatible with the transport unit’s cable,
replace it with a compatible transducer setup using aseptic technique.
• Ensure the IV pressure bag is preset and inflated to 300mmHg with the stopcock closed.
• Place the transducer at the phlebostatic axis and secure with tape
• Zero the line to obtain a “zeroed” reading on the transport monitor
• Flush the line and perform a square-wave test
• Evaluate the waveform and numeric values for correlation with recent patient trends.
Notes:
• Evaluate the insertion site for bleeding, swelling, hematoma, or dislodgement
• Tightly secure stopcocks and cover openings with non-vented endcaps
• Continue monitoring the correlation between NIBP and ABP
• Zero the line after movement of the patient, at mission altitude, and if a suspected erroneous
reading occurs
• If the waveform is dampened, check pressure bag inflation and reassess the position of the
leg/wrist
• If an invasive line is in the femoral artery, keep the patient’s head <30° and leg straight.
Reassess distal pulses with any patient movement
• Flush the line and evaluate the square waveform test as needed
• If the invasive line becomes dislodged, immediately apply direct pressure
**Document procedure, results, and vital signs.**

2026 Standard Medical Operating Guidelines (SMOG) • 209