GE CARESCAPE - Page 272

Cardiacoutput
ProblemSolution
￭Allowthebaselinetostabilizebetween
injections.Ifautomaticprogramisnotbeing
used,allowoneminutebetweeninjections.If
automaticprogramisbeingused,followthe
monitorpromptstoinject.
￭Itisalsorecommendedthatyouinjectatthe
patient’sendexpiration.Thishelpsreduceany
respiratorynoiseandthereforelessenserror.
￭Aminimumdifferenceof10°C(18°F)
betweenthepatientbloodtemperature
andsolution/injectatetemperatureis
recommended.
●Respiration.Thepatient’sinspiratory/expiratory
cycleandplacementofthecatheteraffectsthe
cardiacoutputvalue.Wheneverthepatient
inhalesandexhales,thetemperatureinthelung
changes.Duringinspiration,thepatient’sblood
temperaturedecreasesandduringexpirationit
increases.Therefore,placementofthecatheter
inrelationtoproximityofthelungeldsaffects
thebaseline.Ifthereisasignicantamountof
respiratorynoiseonthepatient’sbaseline,cardiac
outputmaybecalculatedevenifnoinjectionwas
performed.Thereisnodifferentiationbetween
temperaturechangecausedbybreathsversus
injections.Itsimplylooksforachangeinbaseline
temperature.
●Baselinebloodtemperature.Aslittleasahalf
adegreeCelsiuschangeinbloodtemperature
duetorespiratorynoisemaycauseaC.O.value
tobedisplayedwhenaninjectionhasnotbeen
performed.Usingautomodelooksforastable
baselinebeforeallowinganinjection.
●Pulmonaryarterycatheter.Thecatheteritselfmay
bedamaged(e.g.,defectivethermistorordefective
tubing).
●Hemodynamics.Thepatient’srhythmcanaffect
thecardiacoutputvalue.Ifcardiacoutputtrials
arebeingdoneatatimewhenthepatienthas
arrhythmias,youmaynoticeadiscrepancyinthe
cardiacoutputvalues.
●RapidIVsolutions.AnyrapidIVsolutionthatis
infusingatthetimewhenthesolutionisinjected
canalterthecardiacoutputvalue.Maintaina
constantrate,orifpossible,stopthesolution30
secondsbeforetheC.O.injectionandthenrestart
theinfusionafterthecardiacoutputiscalculated.
272CARESCAPEModularMonitors2062971-001