Hey Deb,
I hope you can shed some light on this one for me-it's driving me nuts. I am a PCT and have worked at several units. Most of the units have utilized the rule about the venous pressure should not be any higher than half of whatever you QB i.e at 200QB- the ideal VP should be about 100(maybe 125)-
but then I think that's pushing it. The unit I currently work in uses Cobe3's and I hear that each machine has its own parameters to use around which VP's should be monitored. Do you know this to be true or do you concur with this rule? I know it is driving me nuts because I was taught one way and it doesn't seem to strike anyone else as remotely odd that just about every patient has a VP that is running at least 25-50 points higher than it should at a QB of 200.Is it possible that all of our patients need venograms and fistulagrams done, are we mistaking the flow-(most of them seem to have-or were told they have) arterial flow initiating off the little finger side-Tell me I am not nuts and I am imagining something that isn't there.
Thanks-perplexed in Philly

Ima,

With the Cobe 3, I will be more worried with the pre-pump � Arterial Pressures. The C3 will not run without monitoring the pre-pump AP. If you are not getting the flow the AP will become a more negative number. The VP will be dependant on the needle size as well as the inflow (measured by the pre-pump AP). The C3 might run higher venous pressure than some other machines (due to the bloodlines).

20% of patients have reverse grafts or the arterial side on the thumb side (red thumb). Need to always re-access grafts for correct bloodflow direction. Does your unit use any form of vascular access monitoring? What bloodflow rates is the average for your unit?

The C3 as I remember has a pre-set range for how the alarms are set (points above and below the VP or AP reading). The C3 does have Max readings that the VP or AP will reach and then alarm. Check your C3 manual for the specifications on the alarm limits.

Deborah


[This message has been edited by Deborah Brouwer (edited 07-27-2000).]