Ok all you Neuro ICU RNs- need some help here. So, I'm on my last day of orientation and my preceptor has to leave early today. So I continue on and give report to this "not so welcoming" RN that releived me. Let me first say that neurosurgeries are new to this unit, however, I have worked with head trauma pts with EVDs at previous jobs. Anyway, this pt had an EVD set at +20 open to continuous drain. - not a camino- just a simple EVD drain. I was always taught that you either drain or monitor- not able to do both at the same time. You are off to the transducer and open to drain, then to get an accurate ICP you turn the drain off and then get your waveform and ICP number. That being said, as you are draining, your transducer is off- right?
The oncoming nurse got her panties in a wad because the alarm was off- (because you are not able to continually monitor) so- the number on the monitor is not accurate unless the stopcock is off to drain and such there is no need to alarm a number that is not accurate right?
So, she is telling me that you can monitor trends and you should not need to turn the stopcock to get a reading. How can you monitor a trend when you are off to the transducer? Am I completely nuts? Have I had it all wrong? I know you can do continuous monitoring via camino. But this is just a simple drain.
Nov 8, '08
I hear what you are saying. Even if it is open to the transducer too, it's not an accurate reading, it involves air pressure or something....so my present manager has told me. But, at one place I worked at we were able to monitor the icp while draining (I can't remember the name of the evd).
So, not sure which EVD you are using...as the above poster said, you can measure ICP while draining, but I have used a drain where you couldn't, even if was open to the transducer, it was not an accurate reading. Generally though, best to keep all alarms on. Even if you clamp it for a minute while turning your pt or etc.. , it's nice to hear that alarm when the icp is really high...so you know, oh, i need to open it back up.
I hate ****** nurses, I really do. God does it ruin my day when I have to give report to someone like that.
Last edit by wanderlust99 on Nov 8, '08
: Reason: i thought you were a new nurse