Ventriculostomy/ICP question

Specialties Neuro

Published

In our 30 bed combined Trauma/Neuro/Surgical/Cardiovascular/Cardiac ICU, we are having a bit of a dilemma as to where to level the transducer on our ICP drainage set. We use the Codman system. I was taught by my preceptor that it's levelled to the tip of the ear. I've read in several different areas that it should be levelled to the tragus of the ear and another reference said it should be levelled to the outer canthus of the eye. Which is correct? I know that it DOESN'T get leveled to the phlebostatic axis where we level the transducers for our Swans and Art lines yet some RN's in our unit have done that and then called the MD when the readings were off! Thanks for your help!

Nurse-lou,

That makes sense. It also does sound interesting having everything combined. We have six ICU's in my hospital, however, we often get eachother's overflow. I love taking off service patients because there is always room for learning. Being a CCU we take mainly micu patients but also get alot of surgical traumas, and neuro patients. If the patient is too sick ie) needs a ventric then we will do a lateral transfer. Just like if one of our patients was in neuro and they needed a balloon pump.

Nurse-lou,

That makes sense. It also does sound interesting having everything combined. We have six ICU's in my hospital, however, we often get eachother's overflow. I love taking off service patients because there is always room for learning. Being a CCU we take mainly micu patients but also get alot of surgical traumas, and neuro patients. If the patient is too sick ie) needs a ventric then we will do a lateral transfer. Just like if one of our patients was in neuro and they needed a balloon pump.

Specializes in ICU.

As with CVP, PAWP ETC it does not matter what point you use as a "zero" as long as EVERYONE is using the same point consistantly. I once worked in a unit that zeroed CVP measurements from the sterno-manubrial angle on the basis that it was a more accurate reference when positioning a patient on thier side.

For ICP we actually used a midpoint between ear and eye as a marker for the ventricles. Then you position your patinet onto the side and watch some of the RN's try to zero from the upper ear!

Specializes in ICU.

As with CVP, PAWP ETC it does not matter what point you use as a "zero" as long as EVERYONE is using the same point consistantly. I once worked in a unit that zeroed CVP measurements from the sterno-manubrial angle on the basis that it was a more accurate reference when positioning a patient on thier side.

For ICP we actually used a midpoint between ear and eye as a marker for the ventricles. Then you position your patinet onto the side and watch some of the RN's try to zero from the upper ear!

In my new unit, we have these very fancy little laser levels, which are really nice. Our P&P says the tragus, so that's what we use.

Hi, We level the transducer to the foramne of munro, halfway between the outer canthus of the eye an the pinna. Most of these policies are Doc driven, so whatever they want, and make sure all RNs are doing it the same way.

;)

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