10 waveforms (besides electrocardiogram) every intensivist should be familiar with:
1. Arterial line waveform
Obviously, we need an arterial line. Besides the SBP/DBP/MAP/HR data, there is a ton of info to be obtained regarding tamponade, LVOTO, fluid responsiveness etc
1. Arterial line waveform
Obviously, we need an arterial line. Besides the SBP/DBP/MAP/HR data, there is a ton of info to be obtained regarding tamponade, LVOTO, fluid responsiveness etc
2. Central venous pressure waveform
Obviously, we need a central line in the upper body. Don't follow blindly the hospital's policy. Even a PICC or a dialysis line can be used if absolutely necessary. Info about tamponade, RV function, tricuspid regurgitation etc can be obtained
Obviously, we need a central line in the upper body. Don't follow blindly the hospital's policy. Even a PICC or a dialysis line can be used if absolutely necessary. Info about tamponade, RV function, tricuspid regurgitation etc can be obtained
3. RV - PA - wedge pressure waveforms
I lumped them together because a Swan-Ganz catheter is necessary. The sickest the patient becomes, the more hemodynamic data we need!
I lumped them together because a Swan-Ganz catheter is necessary. The sickest the patient becomes, the more hemodynamic data we need!
4. IABP waveforms
Issues of timing and balloon inflation/deflation are well read by the device itself but we should not view it as a black box
Issues of timing and balloon inflation/deflation are well read by the device itself but we should not view it as a black box
5. Impella waveforms
The SmartAssist console is very helpful and can guide us through troubleshooting (eg, in cases of catheter malposition) but a basic understanding of the waveforms is helpful (work-up of suction events)
The SmartAssist console is very helpful and can guide us through troubleshooting (eg, in cases of catheter malposition) but a basic understanding of the waveforms is helpful (work-up of suction events)
6. Pulse oximeter waveform
It can provide a good amount of hemodynamic information (even raise concern of tamponade...)
It can provide a good amount of hemodynamic information (even raise concern of tamponade...)
8. Ventilator waveforms
This is a hugely important and sadly underemphasized and under-taught aspect of our daily ICU routine. If you were not lucky to be exposed to these concepts during your training, @emireles_c and Seva VentRounds are highly recommended!
This is a hugely important and sadly underemphasized and under-taught aspect of our daily ICU routine. If you were not lucky to be exposed to these concepts during your training, @emireles_c and Seva VentRounds are highly recommended!
9. ICP waveforms
Most of us don't work in neuro-ICUs and don't take care of patients with TBI or catastrophic strokes/SAH but a basic understanding of the components of the ICP waveforms is useful
Most of us don't work in neuro-ICUs and don't take care of patients with TBI or catastrophic strokes/SAH but a basic understanding of the components of the ICP waveforms is useful
10. EEG
OK, we are probably pushing the envelope here to the nerds' territory but if you are not lucky enough to have real-time EEG reading, it helps to be able to see "the basics". Pro move: ask the EEG tech to give you an "off-the-record" assessment before s/he leaves the ICU!
OK, we are probably pushing the envelope here to the nerds' territory but if you are not lucky enough to have real-time EEG reading, it helps to be able to see "the basics". Pro move: ask the EEG tech to give you an "off-the-record" assessment before s/he leaves the ICU!
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