BB
Mrs. Soumya Subramani, M.Sc. (N) 1
PRESENTED BY
Mrs. SOUMYA SUBRAMANI, M.Sc.(N)
LECTURER, MSN DEPARTMENT
CON- SRIPMS, COIMBATORE.
Mrs. Soumya Subramani, M.Sc. (N) 2
Hemodynamic monitoring refers to
the measurement of pressure, flow
and oxygenation within the
cardiovascular system.
Mrs. Soumya Subramani, M.Sc. (N) 3
1) TEMPERATURE MONITORING
2) HEART RATE MONITORING
3) ARTERIAL BLOOD PRESSURE MONITORING - DIRECT & INDIRECT
4) VENOUS PRESSURE MONITORING-JVP& CVP
5) PULMONARY ARTERY PRESSURE MONITORING
6) CARDIC OUTPUT MONITORING
7) TISSUE OXYGENATION
Mrs. Soumya Subramani, M.Sc. (N) 4
Mrs. Soumya Subramani, M.Sc. (N) 5
 NON-INVASIVE METHODS
MERCURY THERMOMETER DIGITAL THERMOMETER
 INVASIVE METHODS- TEMPERATURE PROBE
Mrs. Soumya Subramani, M.Sc. (N) 6
COR BODY TEMPERATURE MONITORING
 TEMPERATURE PROBE
Mrs. Soumya Subramani, M.Sc. (N) 7
Mrs. Soumya Subramani, M.Sc. (N) 8
ECG LEADS
Mrs. Soumya Subramani, M.Sc. (N) 9
DEFINITION
BLOOD PRESSURE IS THE MEASSURE
OF THE FORCE EXERTED ON THE ARTERIAL
WALLS BY THE BLOOD CONTAINED WITHIN THE
ARTERIAL SYSTEM.
Mrs. Soumya Subramani, M.Sc. (N) 10
 USING SPHIGMOMANOMETER
Mrs. Soumya Subramani, M.Sc. (N) 11
TYPES OF SPHIGMOMANOMETERS
Mrs. Soumya Subramani, M.Sc. (N) 12
AUSCULTATORY METHOD
Mrs. Soumya Subramani, M.Sc. (N) 13
OSCILLOMETRIC METHOD
WHEN AN INFLATED CUFF IS PLACED OVER
AN ARTERY, THE PULASTILE PRESSURE
CHANGES IN THE ARTERY WILL BE
TRANSMITTED TO THE INFLATED CUFF
PRODUCING SIMILAR CHANGES IN CUFF
PRESSURE.
Mrs. Soumya Subramani, M.Sc. (N) 14
PROPER FIT OF A BLOOD PRESSURE CUFF
 Width of bladder = 2/3 of upper arm
 Length of bladder encircles 80% arm
 Lower edge of cuff approximately 2.5
cm above the antecubital space
Mrs. Soumya Subramani, M.Sc. (N) 15
Why A Properly Fitting Cuff?
Too small causes false-high reading
Too LARGE causes false-low reading
Mrs. Soumya Subramani, M.Sc. (N) 16
BASIC EQUIPMENTS IN THE PRESSURE MONITORING SYSTEM
 TRANSDUCER
 AN AMPLIFIER WITH A RECORDING SYSTEM
 INVASIVE CATHETER, TUBING & FLUSH SYSTEM
 STOP COCKS
Mrs. Soumya Subramani, M.Sc. (N) 17
Mrs. Soumya Subramani, M.Sc. (N) 18
PRINCIPLES OF INVASIVE
PRESSURE MONITORING
 TO ACCURATELY MEASURE PRESSURE, EQUIPMENTS
MUST BE REFERENCED AND ZERO BALANCED TO THE
ENVIRONMENT AND DYNAMIC RESPONSE
CHARACTERISTICS OPTIMISED.
Mrs. Soumya Subramani, M.Sc. (N) 19
PHLEBOSTATIC AXIS
Mrs. Soumya Subramani, M.Sc. (N) 20
DIAGRAM SHOWING PHLEBOSTATIC AXIS
DEVIATION
Mrs. Soumya Subramani, M.Sc. (N) 21
Mrs. Soumya Subramani, M.Sc. (N) 22
PRINCIPLES OF INVASIVE PRESSURE MONITORING
 ZEROING CONFIRMS THAT WHEN PRESSURE WITHIN
THE SYSTEM IS ZERO,THE MONITOR READS ZERO.
 OPTIMISING DYNAMIC RESPONSE CHARACTERISTICS
INVOLVES CHECKING THAT THE EQUIPMENT
REPRODUCCES, WITHOUT DISTORTION,A SIGNAL THAT
CHANGES RAPIDLY.
Mrs. Soumya Subramani, M.Sc. (N) 23
Mrs. Soumya Subramani, M.Sc. (N) 24
INDICATIONS FOR CENTRAL
VENOUS CANNULATIONS
 ADMINISTATION OF FLUID AND ELECTROLYTES
 DRUG THERAPY
 VENOUS ACCESS FOR MONITORING CVP
 PARENTERAL NUTRITION
 INSERTION OF TRANS VENOUS PACEMAKER
 ADMINISTRATION OF BLOOD &BLOOD PRODUCTS
 LACK OF ACCESSIBLE PERIPHERAL LINE
Mrs. Soumya Subramani, M.Sc. (N) 25
TYPES OF CENTRAL VENOUS
CATHETERS
 SINGLE LUMEN CATHETER
 MULTI LUMEN CATHETERS
Mrs. Soumya Subramani, M.Sc. (N) 26
Central venous pressure interpretation
 NORMAL CVP : 2-6mmHg OR 2-8cmH2O
 HIGH CVP>7mmHg
- NORMOVOLEMIC
RIGHT SIDED HEART FAILURE
CHRONIC BIVENTRICULAR FAILURE
PERICARDIAL DISEASES
PNEUMOTHORAX
PULMONARY STENOSIS
 LOW CVP-HYPOVOLEMIC SHOCK
Mrs. Soumya Subramani, M.Sc. (N) 27
SOURCES OF VARIABILITY
 BODY POSITION
 PRESSURE MONITORING
 UNIT OF MEASUREMENT
PRESSURE MEASURE IN cmH2O CAN
BE DEVIDED BY 1.36 TO BE EXPRESSED IN mmHg.
Mrs. Soumya Subramani, M.Sc. (N) 28
Mrs. Soumya Subramani, M.Sc. (N) 29
Mrs. Soumya Subramani, M.Sc. (N) 30
Mrs. Soumya Subramani, M.Sc. (N) 31
CHG TEGADERM
12/11/2016 @6AM
Mrs. Soumya Subramani, M.Sc. (N) 32
Mrs. Soumya Subramani, M.Sc. (N) 33
Mrs. Soumya Subramani, M.Sc. (N) 34
Mrs. Soumya Subramani, M.Sc. (N) 35
Mrs. Soumya Subramani, M.Sc. (N) 36
 SOLE KLEIN MOESLEY, INTRODUCTION TO CRITICAL
CARE NURSING, SAUNDER’S PUBLICATIONS, FIFTH
EDITION, PG NO:141-171.
 PATRU=ICIA GONE MORTON, DORRIE.K.FONTAINE,
CRITICAL CARE NURSING, LIPPINCOT PUBLICATIONS,
TENTH EDITION, PG NO:263-290.
 PAUL. L. MARINO, THE ICU TEXT B OOK, THIRD
EDITION, PG NO: 153-183.
 BRUNNER & SUDDHARTH’S TEXT BOOK OF MEDICAL
SURGICAL NURSING, LIPPIN COT PUBLICATION, 12TH
EDITION, PG NO: 831-836
 www.manuelsweb.com
 www.pubmed.com
Mrs. Soumya Subramani, M.Sc. (N) 37
Mrs. Soumya Subramani, M.Sc. (N) 38

Hemodynamic monitoring

  • 1.
  • 2.
    PRESENTED BY Mrs. SOUMYASUBRAMANI, M.Sc.(N) LECTURER, MSN DEPARTMENT CON- SRIPMS, COIMBATORE. Mrs. Soumya Subramani, M.Sc. (N) 2
  • 3.
    Hemodynamic monitoring refersto the measurement of pressure, flow and oxygenation within the cardiovascular system. Mrs. Soumya Subramani, M.Sc. (N) 3
  • 4.
    1) TEMPERATURE MONITORING 2)HEART RATE MONITORING 3) ARTERIAL BLOOD PRESSURE MONITORING - DIRECT & INDIRECT 4) VENOUS PRESSURE MONITORING-JVP& CVP 5) PULMONARY ARTERY PRESSURE MONITORING 6) CARDIC OUTPUT MONITORING 7) TISSUE OXYGENATION Mrs. Soumya Subramani, M.Sc. (N) 4
  • 5.
  • 6.
     NON-INVASIVE METHODS MERCURYTHERMOMETER DIGITAL THERMOMETER  INVASIVE METHODS- TEMPERATURE PROBE Mrs. Soumya Subramani, M.Sc. (N) 6
  • 7.
    COR BODY TEMPERATUREMONITORING  TEMPERATURE PROBE Mrs. Soumya Subramani, M.Sc. (N) 7
  • 8.
  • 9.
    ECG LEADS Mrs. SoumyaSubramani, M.Sc. (N) 9
  • 10.
    DEFINITION BLOOD PRESSURE ISTHE MEASSURE OF THE FORCE EXERTED ON THE ARTERIAL WALLS BY THE BLOOD CONTAINED WITHIN THE ARTERIAL SYSTEM. Mrs. Soumya Subramani, M.Sc. (N) 10
  • 11.
     USING SPHIGMOMANOMETER Mrs.Soumya Subramani, M.Sc. (N) 11
  • 12.
    TYPES OF SPHIGMOMANOMETERS Mrs.Soumya Subramani, M.Sc. (N) 12
  • 13.
    AUSCULTATORY METHOD Mrs. SoumyaSubramani, M.Sc. (N) 13
  • 14.
    OSCILLOMETRIC METHOD WHEN ANINFLATED CUFF IS PLACED OVER AN ARTERY, THE PULASTILE PRESSURE CHANGES IN THE ARTERY WILL BE TRANSMITTED TO THE INFLATED CUFF PRODUCING SIMILAR CHANGES IN CUFF PRESSURE. Mrs. Soumya Subramani, M.Sc. (N) 14
  • 15.
    PROPER FIT OFA BLOOD PRESSURE CUFF  Width of bladder = 2/3 of upper arm  Length of bladder encircles 80% arm  Lower edge of cuff approximately 2.5 cm above the antecubital space Mrs. Soumya Subramani, M.Sc. (N) 15
  • 16.
    Why A ProperlyFitting Cuff? Too small causes false-high reading Too LARGE causes false-low reading Mrs. Soumya Subramani, M.Sc. (N) 16
  • 17.
    BASIC EQUIPMENTS INTHE PRESSURE MONITORING SYSTEM  TRANSDUCER  AN AMPLIFIER WITH A RECORDING SYSTEM  INVASIVE CATHETER, TUBING & FLUSH SYSTEM  STOP COCKS Mrs. Soumya Subramani, M.Sc. (N) 17
  • 18.
  • 19.
    PRINCIPLES OF INVASIVE PRESSUREMONITORING  TO ACCURATELY MEASURE PRESSURE, EQUIPMENTS MUST BE REFERENCED AND ZERO BALANCED TO THE ENVIRONMENT AND DYNAMIC RESPONSE CHARACTERISTICS OPTIMISED. Mrs. Soumya Subramani, M.Sc. (N) 19
  • 20.
    PHLEBOSTATIC AXIS Mrs. SoumyaSubramani, M.Sc. (N) 20
  • 21.
    DIAGRAM SHOWING PHLEBOSTATICAXIS DEVIATION Mrs. Soumya Subramani, M.Sc. (N) 21
  • 22.
  • 23.
    PRINCIPLES OF INVASIVEPRESSURE MONITORING  ZEROING CONFIRMS THAT WHEN PRESSURE WITHIN THE SYSTEM IS ZERO,THE MONITOR READS ZERO.  OPTIMISING DYNAMIC RESPONSE CHARACTERISTICS INVOLVES CHECKING THAT THE EQUIPMENT REPRODUCCES, WITHOUT DISTORTION,A SIGNAL THAT CHANGES RAPIDLY. Mrs. Soumya Subramani, M.Sc. (N) 23
  • 24.
  • 25.
    INDICATIONS FOR CENTRAL VENOUSCANNULATIONS  ADMINISTATION OF FLUID AND ELECTROLYTES  DRUG THERAPY  VENOUS ACCESS FOR MONITORING CVP  PARENTERAL NUTRITION  INSERTION OF TRANS VENOUS PACEMAKER  ADMINISTRATION OF BLOOD &BLOOD PRODUCTS  LACK OF ACCESSIBLE PERIPHERAL LINE Mrs. Soumya Subramani, M.Sc. (N) 25
  • 26.
    TYPES OF CENTRALVENOUS CATHETERS  SINGLE LUMEN CATHETER  MULTI LUMEN CATHETERS Mrs. Soumya Subramani, M.Sc. (N) 26
  • 27.
    Central venous pressureinterpretation  NORMAL CVP : 2-6mmHg OR 2-8cmH2O  HIGH CVP>7mmHg - NORMOVOLEMIC RIGHT SIDED HEART FAILURE CHRONIC BIVENTRICULAR FAILURE PERICARDIAL DISEASES PNEUMOTHORAX PULMONARY STENOSIS  LOW CVP-HYPOVOLEMIC SHOCK Mrs. Soumya Subramani, M.Sc. (N) 27
  • 28.
    SOURCES OF VARIABILITY BODY POSITION  PRESSURE MONITORING  UNIT OF MEASUREMENT PRESSURE MEASURE IN cmH2O CAN BE DEVIDED BY 1.36 TO BE EXPRESSED IN mmHg. Mrs. Soumya Subramani, M.Sc. (N) 28
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  • 30.
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  • 32.
    CHG TEGADERM 12/11/2016 @6AM Mrs.Soumya Subramani, M.Sc. (N) 32
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  • 37.
     SOLE KLEINMOESLEY, INTRODUCTION TO CRITICAL CARE NURSING, SAUNDER’S PUBLICATIONS, FIFTH EDITION, PG NO:141-171.  PATRU=ICIA GONE MORTON, DORRIE.K.FONTAINE, CRITICAL CARE NURSING, LIPPINCOT PUBLICATIONS, TENTH EDITION, PG NO:263-290.  PAUL. L. MARINO, THE ICU TEXT B OOK, THIRD EDITION, PG NO: 153-183.  BRUNNER & SUDDHARTH’S TEXT BOOK OF MEDICAL SURGICAL NURSING, LIPPIN COT PUBLICATION, 12TH EDITION, PG NO: 831-836  www.manuelsweb.com  www.pubmed.com Mrs. Soumya Subramani, M.Sc. (N) 37
  • 38.