Page 243 - 2023 SMOG Digital

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 transport unit’s cable,
replace with compatible transducer setup using aseptic technique.
• Ensure IV pressure bag is preset and inflated to 300mmHg with stopcock closed
• Place transducer at 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 waveform test
o 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 correlation between NIBP and ABP
• Zero the line after movement of patient, at altitude, and if suspected erroneous reading
o Adjust/re-calibrate monitor every 1000ft if required based upon monitoring device
• If waveform dampened, check pressure bag inflation and reassess position of leg/wrist
• If invasive line is in the femoral artery, keep patient head <30° and leg straight.
Reassess distal pulses with any patient movement
• Flush line and evaluate square waveform test as needed
• If invasive line becomes dislodged, immediately apply direct pressure

243