PA Catheter (Overview)

ICU · ICU/Cardiology · 10–20 min

Pulmonary artery catheter for hemodynamic monitoring — rarely used now.

Indications

  • Selected shock states with diagnostic uncertainty

Contraindications

  • Right-sided endocarditis
  • LBBB (may need pacing)

Equipment

  • Introducer + PA catheter
  • Pressure transducer
  • ECG monitoring

Positioning

  • As appropriate for the procedure and patient comfort.

Consent

  • Explain indication, benefits, alternatives
  • Explain risks & complications
  • Obtain written/verbal consent as per SOP
  • Document consent

Universal precautions

  • Hand hygiene
  • PPE — gloves, mask, eye protection
  • Aseptic technique
  • Sharps safety
  • Verify patient identity & site

Step-by-step (0/4)

Tap to complete

1. Insert via IJ/subclavian

Introducer sheath as CVC.

2. Float catheter

3. Confirm wedge

4. Interpret

Immediate complications

  • Arrhythmia
  • PA rupture
  • Knotting

Delayed complications

  • Thrombosis
  • Infection

Recognition

  • Sustained VT
  • Sudden hemoptysis

Initial management

  • Deflate balloon; escalate

Prevention

  • Trained operator

Post-procedure observation

  • Vitals q15min × 1h then hourly

Monitoring

  • Site inspection
  • Symptom review

Documentation

  • Procedure note
  • Consent
  • Findings

Patient instructions

  • Report pain, bleeding, fever, worsening symptoms

Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.

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