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Discussion

CSF samples

How do you draw CSF from your hospitals EVD? I was taught to draw using a needle and syringe from the injection port right below the drip chamber, however when sampling with a different nurse he removed the injection port and replaced it with a reflux valve to lock the syringe into. He then replaced it again with the previous injection port. His reasoning was that he didn't want to aspirate off the injection port and leave an entry for microbes afterwards.  I recently started traveling so I am curious what other facilities are doing. I tried looking for this facilities policy but was unable to locate. 

Do you use biopatches for the insertion site?  And are you using betadine, chlorohexidine, or alcohol swabs? This facility recently switched to using alcohol swabs but I was always taught that the alcohol is neurotoxic which is why it's avoided

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    At my facility we use the proximal stopcock - remove the cap, clean with chlorhexidine, slowly aspirate, then replace with a new sterile cap. Two nurses are there to keep it as sterile as possible. I recently saw a study that showed you can sample from the stopcock on the drip chamber without affecting results. 

    Haven't heard of sampling from the bag. The most recent sample I sent was to see if an infection had developed. There could be more than a week of drainage in the bag that would throw those results off.

    Most of our surgeons use a biopatch with a transparent dressing. Some initially use a dressing then leave it open to air.

    It's different everywhere. Best thing to do would be to just ask what the policies are.

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