How to Float a PA (Swan-Ganz) Catheter
1) Place an introducer catheter, usually 15 to 20cm, into a central vein, most commonly the RIJ.
2) Flush each port of the catheter and check the balloon integrity by inflating and deflating. Put on the swan cover. 
3) With the balloon down, insert the catheter into the introducer to a depth about 2cm distal to the length of the introducer. (This ensures the balloon is outside of the introducer lumen when inflated).  Be sure to maintain the natural curve of the PA catheter such that is curves towards the PA.
4) Inflate the balloon and begin to advance, watching the waveform as you go. As I mentioned, think of the balloon as a raft, and the blood flow carrying it to its destination!

David Convissar, MD @countbackwardsfrom10

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