[ChristineAk.]

Hello Everyone,
I'm taking a Nursing Informatics and Technology course this summer. I have a presentation in this class and I have choosen the ICP Monitor as my subject. I looking for a few people who could briefly share their experiences using this type of technology. I have a basic knowledge of how the monitor works, but the main focus of this project is the nurse's reaction/experience not it's operation.

For example:
Pros/Cons




User friendly?



What was the predecessor?
How did that differ from ICP monitor of today?


Observations of the patient's reactions


Your time, consideration and input very much appreciated!

Regards,
Christine

[gwenith]

Sorry Chrisitne but the subject is a little more complicated than that.

I.E. What site are you using for your ICP monitoring - Intraventricular, subdural or parenchymal? Each have different pro's and cons.

In Neuro you also have the consderation of whether you are using a classic fluid filled transducer system or a fibre optic system for measurement.

[ChristineAk.]

Gwenith,
Sorry I was so vague, I'm a bit embarrassed by my ignorance in this subject!
It's the Intraventricular ICP Monitor that I'm interested in, but I'm not sure if it's the fiber optic fluid fillled transducer that's used. I understand that it can be the most accurate, it can drain CSF as well, but it's highly invasive and theres an increased chance of infection.

Thank You,
Christine

[gwenith]

If it can drain CSF then it is probably a fluid filled system and not a fibre optic. The fibre optic ones are the most accurate and because they do not have the fluid are slighlty less prone to infection.

I would suggest that you first read Mark Hammerschmidts information package

http://www.icufaqs.org/ICPMonitoring.doc

Come back with more questions after you have read this.

[gwenith]

BTW there is a whole thread devoted to neuro websites that is "stuck" to the top of this forum!!!

[crna2bee]

Does this ICP monitor have a protruding bolt from the patient's head? If so this is an Camino ICP bolt which was inserted. There are 2 types of Camino bolts, 1 is strictly for monitoring ICP, the second has an extra port on the tubing for draining fluid, i.e. CSF, Blood, this tube is then connected to a Becker drain. There is also a Ventricluostomy system that is usually connected to a Becker drainage system, in this system there is no bolt, just a catheter (white) which is about the diameter of IV tubing placed in the chosen area. The third type of ICP monitor system is the Codman System. This is the fiberoptic catheter system you are describing. This system is used only for monitoring, not drainage. It is primarily used for pt's with brain swelling issues (C.H.I.) not issues of hydrocephalus where csf/blood drainage is required. If you witnessed the monitor palced at the bedside, then it was most definitely a Camino ICP bolt which can be easily placed in around 15 minutes on a pt. The other monitors are usually placed in the O.R. under anesthesia.

The advantages and disadvantages really have to do with what monitor is right for your pt's condition.

[JJRN]

Codman and Becker are just company names...companies that make a variety of monitoring systems that function via different means. Also, EVDs or IVCs are commonly placed at bedside c sedation administered by the RN. I have never sent a pt to the OR strictly for placement of an ICP monitoring device. Of course they do at times come to the unit from the OR after a crani c a monitor. The specifics of placement method and brand/device used is certainly facility dependent. For your project, you stated you wanted to concentrate on IVCs (intraventricular catheters). You can discuss the implications for usage, prep for insertion, care/assessment of device/pt with device, troubleshooting, and most importantly required interventions for increased ICPs. Patients requiring placement of this device most often are not in a mental state to comprehend what is occuring, so they really don't have a reaction, at least in my experience. Patients are experiencing some altered neuro status, which alters LOC/awareness, to require ICP monitoring. Nurses must be diligent to exhaust all nursing interventions to decrease ICPs and act quickly and correctly to intervene otherwise as appropriate. I once read the stats on occurence of secondary injury d/t elevated ICPs, decreased CPP, decreased cerebral blood flow, and hypoxia and one of these factors need be present for a only short period (less than 20 minutes) of time to cause irreversable neurological damage. Honestly, there is so much to talk about with this topic so I was trying to be general. Hope this helps you.

[gwenith]

JJRN thank-you for your responses I was starting to wonder if we were totally different over here in Aust. We don't always have the access to equipment you do for a variety of reasons the main one being the comparitively small market means that a lot of companies don't bother.