[slholmes]

Hello, I am new to the forum and also a new nurse to the Neurosurgical ICU. It can be very frightening and overwhelming for someone new to the unit when they have not worked in neuro before and I am having a difficult time learning all the new information. I have been in the unit 6 weeks now, and I was looking for any websites that would give me diagramatic information on how to set up EVDs. I am finding that I am not so sure about which way to turn the stopcocks, it all seems confusing to me (ie. measuring ICPs vs. draining fluid off). Hopefully the next few weeks will get better, I am feeling so anxious when I have to go into work, I am wondering if I have gotten myself in way over my head to choose the Neurosurg. ICU

newby nsicu nurse

[ELKMNin06]

Originally Posted by slholmes

Hello, I am new to the forum and also a new nurse to the Neurosurgical ICU. It can be very frightening and overwhelming for someone new to the unit when they have not worked in neuro before and I am having a difficult time learning all the new information. I have been in the unit 6 weeks now, and I was looking for any websites that would give me diagramatic information on how to set up EVDs. I am finding that I am not so sure about which way to turn the stopcocks, it all seems confusing to me (ie. measuring ICPs vs. draining fluid off). Hopefully the next few weeks will get better, I am feeling so anxious when I have to go into work, I am wondering if I have gotten myself in way over my head to choose the Neurosurg. ICU

newby nsicu nurse

Remember it works by gravity. Always close it when you move your pt. so you can re level!

[neurogeek]

Originally Posted by slholmes

Hello, I am new to the forum and also a new nurse to the Neurosurgical ICU. It can be very frightening and overwhelming for someone new to the unit when they have not worked in neuro before and I am having a difficult time learning all the new information. I have been in the unit 6 weeks now, and I was looking for any websites that would give me diagramatic information on how to set up EVDs. I am finding that I am not so sure about which way to turn the stopcocks, it all seems confusing to me (ie. measuring ICPs vs. draining fluid off). Hopefully the next few weeks will get better, I am feeling so anxious when I have to go into work, I am wondering if I have gotten myself in way over my head to choose the Neurosurg. ICU

newby nsicu nurse

Where the heck is your preceptor???? If you're that new u shouldn't be working alone. You need to go to the unit manager & get her to assign u a resource person each shift to help u with this stuff. Never second guess neuro. It's vital that you recognize your weaknesses (which u have) but then follow through on the spot by seeking out help. If they aren't supporting u with a resource they are putting you in danger, your patient in danger, and the unit/hospital in danger. As for a resourece, I suggest you buy "The Clinical Practice of Neurological and Neurosurgical Nursing" by Joanne Hickey.

[auzzieneuronurse]

It is a bit scarey that they have left someone to look after an EVD with no theoretical background knowledge of how it works and how to look after it!! If you are after more practical, specific info I'd suggest you search for the company that produces the drains in your specific unit as they often have good diagrams. e.g.Johnson and Johnson EVD's will come up with www.codman.com

[TulsaTime]

I'm curious about something on this topic as well. I recently changed hospitals and the place i am at now turns the stopcock off to the drain to read their icps. i was always taught you could leave it on to the drain & to the patient & get your icp readings. Also just curious, how often do you document your evd outputs? i'm accustomed to every hour but where i am now they often do it every 4 or 8 hours instead.

[RoxanRN2003]

What system do you use? How can you drain and get a pressure reading at the same time through the transducer? With the system we use, we have to turn the stopcock off to get ICP readings (as well as wave forms). We also document hourly output and pressure.

[TulsaTime]

Originally Posted by RoxanRN2003

What system do you use? How can you drain and get a pressure reading at the same time through the transducer? With the system we use, we have to turn the stopcock off to get ICP readings (as well as wave forms). We also document hourly output and pressure.

It's a codman system. You can turn the stopcock so that it is on to the transducer & the drain at the same time. Your waveform is not as good but it gives you a mean. When I turn off to the drain I still get the same number but my waveform doesn't look as dampened.

[kimtab]

We turn it off to the drain to get a pressure reading. If you had it open to drain and patient wouldn't the transducer be getting the pressures from both sides? Doesn't seem like that would be accurate. We document drainage and pressure q1h.