First Things First (assess & treat for the following)

• All mathematical calculations are adjuncts to clinical decision-making.
• Never substitute arithmetic for clinical judgment!
• If you did not personally collect the data on which you are basing these calculations, then be sure it was accurately obtained.
  • Garbage in, garbage out, period!
• If the “numbers” suddenly change & they do not fit the clinical picture, then you should personally corroborate their accuracy BEFORE you base any therapies on these values.
• If you subject a pt to the risk of inserting a PA catheter, then you should personally look at the waveform tracings from the first set of “numbers” & be sure that you agree w/ the submitted values.
• If these data are to be of value, then you must interpret them in the context of dynamic pt care & you must understand the underlying physiologic principles.
  • There is no one fixed hemodynamic value that remains the best value for that pt over an extended period of time.