RT Book, Section A1 Neuman, J. Elizabeth A1 Mann, Jessica A2 Reichman, Eric F. SR Print(0) ID 1159798402 T1 Pulmonary Artery (Swan-Ganz) Catheterization T2 Reichman's Emergency Medicine Procedures, 3e YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9781259861925 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1159798402 RD 2024/10/11 AB The concept of invasive hemodynamic monitoring was first pioneered in the mid-1800s. After that time, various devices and techniques evolved until Swan and Ganz developed the balloon-tipped pulmonary artery catheter (PAC) in 1970.1-3 The “Swan-Ganz catheter” has been used almost exclusively in the intensive care setting ever since, with an estimated 1 million PACs placed annually at a cost of approximately 2 billion dollars.4,5 The use of the PAC has allowed clinicians to measure right atrial, pulmonary artery, and pulmonary capillary wedge pressures at the bedside.6 Although advanced hemodynamic monitoring would seem intuitively to help clinicians in the management of unstable patients, the PAC has not been found to improve survival, and its use has declined significantly over the past 20 years.7 While the utility of the PAC has become less clear, particularly with advances in less invasive monitoring techniques, it is still used in complex cases.8 This chapter focuses on the actual technique of placement of the PAC and is predicated on the ability of the Emergency Physician (EP) to gain central venous access (Chapters 63 and 64).