Equipment

  • Pressure bag able to inflate to 300 mmHg
  • 500 mls Saline solution with iv additives label
    • Consider adding 500 iu heparin (document in chart if given)
  • 2 ml syringe and green needle
  • 1000 units refrigerated heparin
  • Two pressure modules with pressure cables
  • Single or dual transducer set (comes complete with giving set) with transducer holder (if available)
  • Suitable cardiac monitor with invasive pressure monitoring
  • Gloves
  • Narrow width tape

Procedure

  • Gather equipment together
  • Test integrity of pressure bag (check for leaks, breaks, faulty dial…)
  • Insert the pressure modules into the cardiac monitor by clicking them in place (for CVP monitoring, both modules will still be required)
  • Apply gloves; check and draw up the heparin (complete an iv additives label)
  • Add the heparin to the saline solution and shake well
  • Attach the transducer set and prime
  • Connect the saline to the pressure bag
  • Ensure the saline rests in the centre of the pressure bag
  • Inflate the pressure bag as it rests on the counter
  • Inflate to 300 mmHg
  • Hang the pressure bag up
  • Take care to close all ports open to air when priming the lines
  • 'Squeeze' the fluid through the lines (using the blue and red flush valves)

Arterial line

  • Connect the arterial tubing (red) to the patient’s arterial access
  • Connect the white pressure cable inserted in the first pressure module to the white transducer cable
  • To zero, turn the white tap ‘off’ to the patient, i.e., in the direction of the patient, and open the orange port to air
  • Press zero on the arterial pressure module. Hold it down until the monitor states ‘arterial zero done’
  • Turn the white tap ‘off’ to air and close the orange port
  • Ensure arterial access site remains visible at all times
  • Using tape and a red pen, label the arterial line clearly with the letters 'ART'

CVP line

  • Ensure CVP line stitched in, flushed through and secured with tegaderm
  • Connect the white CVP connector to monitor
  • Connect the grey pressure cable inserted in the second pressure module to the white transducer cable
  • To zero, turn the white tap ‘off’ to the patient and open the orange port to air
  • Press zero on the CVP pressure module. Hold it down until the monitor states ‘CVP zero done’
  • Turn the white tap ‘off’ to air and close the orange port
  • Secure the ‘red’ and ‘blue’ flush valves at the level of the patient’s right atrium.
  • Tape them, if necessary to the patient's mid upper arm, at the level of the heart.

Re-zero

Re-zero the arterial and/or central venous pressures if:

  • The equipment becomes disconnected in any way
  • The patient’s position alters
  • Monitoring is transferred to a different machine, i.e., for transfers