Section 2--Waveform practice

 

This section presents a series of Swan-Ganz Waveforms for your evaluation. For each, you must select two pieces of information:

 

  1. The identity of the waveform (i.e., the location of the catheter tip)

    2.  

  2. An evaluation of the Pressure measurement compared to Normal (High, Normal, Low)

 

Remember to take your time as this is for teaching not testing. You may repeat this section as often as you like.

 

Wave 1-Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure?

Graphic is in mm Hg on Y axis, time plus waveform on X axis.

 

Interpretation--Wave 1-PA, Normal--This is a PA tracing as one can visualize systole, the dicrotic notch and diastole. The pressures for systole (15-28 mm Hg) and diastole (5-16 mm Hg) are normal.

Wave 2--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

Interpretation--Wave 2-CVP, Normal--Systole and Diastole are not clearly distinguishable and the pressure is within normal range (2-7 mm Hg).

Wave 3--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

Interpretation--Wave 3- PA, Low--Systole, the Dicrotic notch and Diastole are clearly seen, but all the pressures are low.

Wave 4-- Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

Interpretation--Wave 4-PCWP, Normal--Clinical information would be needed to separate this from a CVP waveform that was high pressure.

Wave 5---Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

 

Interpretation--Wave 5-PA, high--Systole, the Dicrotic Notch and Diastole are present but at higher values than normal.

Wave 6--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

 

Interpretation--Wave 6-RV, Normal--Systolic Pressures (15-28 mm Hg) and Diastolic Pressures (0-8 mm Hg) are normal. The dicrotic normal is very faint.

Wave 7--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

Interpretation--Wave 7--PCWP, high--Systolic and Diastolic pressures are not distinguishable. This is a mean pressure higher than the normal 6-15 mm Hg.

Wave 8--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing. Is it 1) High 2) Normal 3) Low Pressure

 

Interpretation--Wave 8--RV,high--Systole and Diastole with a faint dicrotic notch are visible but all the pressures are higher than normal.

Wave 9--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 

 

Interpretation--Wave 9-PCWP, Low--Clinical information would be needed to distinguish this from a CVP wave that was normal.

Wave 10--Is this a 1) CVP 2)PA 3)PCWP 4) RV Tracing.

Is it 1) High 2) Normal 3) Low Pressure

 Interpretation--Wave 10-CVP, High

 

Compute Scores--Interpretation without clinical information is many times impossible!

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