|"What do the numbers and lines on the monitor mean?"|
|This is a difficult question to answer without being able to see the actual monitor. What is listed below are some of the things routinely monitored in an ICU with brief explainations. If you have more specific questions about your loved one's monitor, ask your nurse.
Usually, the first couple of lines are the heart rhythm. There are far too many variations of heart rhythm to list here. Your nurse will tell you if it is regular or irregular, fast or slow, and whether or not it is desirable. Undesirable rhythms, called arrhythmias, usually can be fixed with medications and other treatment, but not always.
Another line you might see is the arterial blood pressure, seen on the monitor as labeled ART or ABP. This is a graphic representation of the blood pressure as measured by a special catheter placed directly in an artery, usually in the wrist, but sometimes in other parts of the arm or groin. The advantage of the arterial pressure, as opposed to a regular blood pressure cuff, is that we can see immediate changes in blood pressure. Arterial lines are very sensetive and might not always be accurate, so ask your nurse about the blood pressures you see before starting to worry about highs and lows. Sometimes arterial lines are put in to assist in drawing blood, so your loved one doesn't have to be stuck by needles too many times.
Also on the monitor might be the pulmonary artery pressure (PAP, PA, or PULM). This is another blood pressure reading that is being taken by a catheter usually in the neck or just below the collarbone, although the groin is sometimes used. If you see a long, usually yellow, line with a plastic sheath and lots of ends, that is the pulmonary catheter. This catheter is about three feet long and goes through the heart and into the blood vessels of the lungs. Many useful measurements can be taken with the pulmonary catheter, also called a "Swan" (short for Swan-Ganz, the two physicians that developed the catheter). Some of the readings include a cardiac output (tells us how well the heart is pumping), SvO2 (an indication of the oxygen used by the body), pulmonary artery occlusive (or wedge) pressure (an indication of how much fluid is pumped by the heart), and central venous pressure or right atrial pressure (see below).
The central venous or right atrial pressure (CVP, RA) is also an indication of fluid status. Although less accurate than the pulmonary artery occlusive pressure, it can be measured without a pulmonary artery catheter and, therefore, usually a less invasive procedure.
Intracranial pressure, or ICP, is the measure of pressure around the brain. If your loved one has a tube coming out of the top of his head, ask your nurse if they are measuring the ICP. Sometimes a tube is put in the skull simply to drain excess fluid.
Oxygen saturation is also frequently measured, seen on the monitor as SpO2 or Pleth. This uses a small infrared sensor, usually on the finger, to measure how much oxygen is in the blood.
NIBP, means non-invasive blood pressure. NIBP won't have a line, just numbers. This is the automatic blood pressure cuff.
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