ICP Transducers

  1. 0 I am curious about nursing practice of other NeuroICUs regarding ICP transducer changes. I work in a 20-bed NeuroICU with a large SAH population. Most of these patients' EVD stay in place for more than a week. Our unit policy is to change the transducer every 4 days, using aseptic technique. It is also our policy to use aseptic technique when initially setting up the EVD system, including the attachment of the transducer to the monitoring port of the EVD system. Subsequent changes of the transducer, seem to be breaking the integrity of the system and could potentially contaminate it. We are thinking of changing this policy. Inputs are highly appreciated. Thanks!
  2. Visit  Treb4K profile page

    About Treb4K

    Joined Aug '05; Posts: 2.

    28 Comments so far...

  3. Visit  Jessy_RN profile page
    0
    Hello and welcome to the family of allnurses. Good luck to you. :angel2:
  4. Visit  bellehill profile page
    0
    I work in a 18 bed neuro ICU, we use sterile technique when setting up the EVD, we never change the transducer after it is inserted. Our patients are always on Ancef 1gm q8h while the EVD is in as well. It doesn't make sense to change the transducer, what was the reasoning behind that policy?
  5. Visit  bjpeace profile page
    0
    I agree, my 8 bed unit puts them in under sterile, and doesn't change unless they go back to the OR.
  6. Visit  hrtprncss profile page
    0
    we only zero and mess with the transducer in the beginning during insertion of evd/icp with the neurosurgeon, u dont need to rezero it, bad idea, at least we're not allowed to. if things go haywire then we take one out and put another one in.
  7. Visit  RoxanRN profile page
    0
    We routinely zero (to the monitor) ICP transducers as well as art lines and CVPs at the beginning of each shift. Also, we don't open/change out the ventric system unless we have no other choice (line clotted and won't flush though) and then we do it as aseptically as possible. Ventric patients are also on Ancef for the duration.
  8. Visit  NICU_RN_CN profile page
    0
    We dont change the set up unless there is a problem as well and the pt is on ancef routine until drain is D/C'd. Infection control department has been ok with this practice for the last 6 years that I know of and are always watching out for our infection rates. Your CVL sites have higher rate of infection than the Ventric.
  9. Visit  pixieelb profile page
    0
    Hello All !

    I work in 16 bed interdisciplinary ICU. We never change the transducer after ICP-catheter is inserted. There isn't any reason in reference of sterility -unless...critical point... anything is going out of order .
    Generally you don't have to flush the system. Further more the ICP-catheters "Spiegelberg" & "Codman" description says, you don't have to routinely zero as long as device and monitor display the same value. The devices do it self, among others "Spiegelberg" each hour.
    We only zero in the beginning or after disconnected (...if the device make troubles *further no comment necessary).

    greetz
  10. Visit  gwenith profile page
    0
    As far as I know you do have to zero the fluid filled ICP monitors because the atmospheric pressure does change the reading (however technology might have changed this dictum - watch this space ) The fibre-optic systems do not need zeroing except just before insertion and never need zeroing afterwards unless there is a real problem.
  11. Visit  gwenith profile page
    0
    Quote from pixieelb
    Hello All !

    I work in 16 bed interdisciplinary ICU. We never change the transducer after ICP-catheter is inserted. There isn't any reason in reference of sterility -unless...critical point... anything is going out of order .
    Generally you don't have to flush the system. Further more the ICP-catheters "Spiegelberg" & "Codman" description says, you don't have to routinely zero as long as device and monitor display the same value. The devices do it self, among others "Spiegelberg" each hour.
    We only zero in the beginning or after disconnected (...if the device make troubles *further no comment necessary).

    greetz
    The Codman system is like the Camino system - no fluid
    The Codman ICP Monitoring System provides highly accurate measurements of intracranial pressure at the source-subdural, parenchymal or intraventricular levels. The information is relayed electronically rather than through a hydrostatic column or fiberoptics. (117 v)
    http://www.medcompare.com/details/15...P-Express.html

    That is why you don't have to zero
  12. Visit  Keysnurse2008 profile page
    0
    Quote from treb4k
    i am curious about nursing practice of other neuroicus regarding icp transducer changes. i work in a 20-bed neuroicu with a large sah population. most of these patients' evd stay in place for more than a week. our unit policy is to change the transducer every 4 days, using aseptic technique. it is also our policy to use aseptic technique when initially setting up the evd system, including the attachment of the transducer to the monitoring port of the evd system. subsequent changes of the transducer, seem to be breaking the integrity of the system and could potentially contaminate it. we are thinking of changing this policy. inputs are highly appreciated. thanks!
    [font="garamond"]we do not ever break that closed system.by changing transducers you have 1.broken that closed sterile system 2.increased your patients chances of getting bacterial meningitis by about 50k times. 3. why...would your neurosurgeons ok such a technique?esp...aseptic....i mean....that can be quite lethal .
    to answer your question...never...we never change that transducer.if the patient cant shunt that excess csf himself...we take them to the or and place a vp or a va shunt in.if...if....that drain is in for over 10 days....the neurosurgeon will under sterile technique..replace the entire system- ventric cath and all...just like the surgical sterile procedure he initially did when he inserted it.......but to break that closed system....no way!!!patient safety...always think patient safety!!!!!
    Last edit by Keysnurse2008 on Jan 24, '06
  13. Visit  joanna1975 profile page
    0
    Our practice is much the same as RoxanRN2003. We also zero ICP transducers as well as A lines and CVPs at the beginning of each shift. The bolts occassionally get inserted by the Registrar aseptically in the ITU but more often than not they get inserted and changed (if need be) in theatre.
  14. Visit  Keysnurse2008 profile page
    0
    Quote from joanna1975
    our practice is much the same as roxanrn2003. we also zero icp transducers as well as a lines and cvps at the beginning of each shift. the bolts occassionally get inserted by the registrar aseptically in the itu but more often than not they get inserted and changed (if need be) in theatre.
    [font="lucida sans unicode"]sure we zero the alines ,cvps, and icps during the shift.but we dont ever break that closed system to change out a transducer.the evd's are placed under sterile technique at the bedside....and if in for over 10 days the neurosurgeon will replace the entire system( cath and all) under sterile technique at the bedside.but..at the neuro icu's i have worked at we feel that breaking that closed sterile system by changing out that transducer is a risk we arent prepared to take. first of all bc the patient is critical or they wouldnt have that drain stuck in their vents to begin with...and secondly bc we dont want to possible introduce bacteria or contaminants into that sterile line.i am sure diff hospitals have diff policies re: this....but i am curious as to what the rationale your hospital and neurosurgeons have re: changing these transducers under aseptic technique?why are they having you guys do that?just curious...


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