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Monitoring ICP in the OR.



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Aug 31, 2008 09:49 PM

Monitoring ICP in the OR.


I am new to PACU and have been an ICU for 8 years. I recently recieved a patient in the PACU with a ventric that was connected to a pressure bag. I have never experienced it being set up with a pressure bag and have been taught that it was contraindicated. The reason being is that the pressure bag adds 2 mls an hour to keep the line open. Unfortunately the pressure bag also was heparinized. I immediately stated my concerns and then spoke with Anesthesia in regards to my concerns. They stated that this is normal in the OR, because the drainage system is open. They monitor the ICP for brief periods and then shut it off. Does anyone have any resources in regards to this? Is this contraindicated to attach a pressure bag? I believe the heparin is an unsafe practice d/t many reasons i.e. HIT and bleed to be the most concern.


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3 Comments
No. 1
from nrsang97
Old Sep 05, 2008, 01:05 AM

Default Re: Monitoring ICP in the OR.
I have NEVER used a pressure bag (and with heparin??) with Ventrics. Dosen't make any sense. We have the transducer on the EVD set up and transduce to the monitor. All they have to do to measure is turn the stop cock off to drainage and measure and re open. I still cannot believe the neurosurgeon didn't say anything. What are they thinking?
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No. 2
from labman
Old Sep 06, 2008, 03:47 PM

Default Re: Monitoring ICP in the OR.
Our neurosurgeons would have been so ****** if they would see that
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No. 3
from nrsang97
Old Sep 06, 2008, 04:49 PM

Default Re: Monitoring ICP in the OR.
http://www.noahslifewithhydrocephalu...a/DSC02294.JPG


In this link shows a child with a EVD in place. There is no pressure bag. This system is different because we use Integara drains. But maybe this will help. icufaqs.org has good info on EVD's and ICP monitoring as well.
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