ICP Transducers

[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!

[auzzieneuronurse]

Not sure how you can zero the system to atmospheric pressure if you don't remove the cap?? We zero the system once a shift in a completely sterile procedure and change the cap at the same time.

[gwenith, BSN, RN]

It goes back to my answer that there are two distinct types of monitoring system in Neuro. One uses fibre-optic cable, which since it is NOT a fluid filled device, does not need opening to atmosphere to zero - the other relies on pressure waves transmitted through fluid and does need opening to atmosphere to zero.

[poppy07]

It was my first day working with an EVD, and I had to hook it up to the transducer and monitor. Was it ridiculous to think that it might need a pressure bag to generate a waveform on the monitor, as does a CVP, art-line, etc?

Another RN set this up but did not explain as I was helping with another procedure.

Thanks.

[GrnHonu99, RN]

we have the fluid chambered EVDs that transduce ICPs and they must be zeroed to the pt. as they work on gravity. Soo everytime the pt. moves or changed position we have to re zero the EVD..also dangerous if you have a stubborn pt. that wants to stand stright up and dump CSF. We also use the codman wires, they dont need to be rezeroed.

Oh and we never, ever, replace the transducers..that just opens the system...we do change the fluid bag when it gets full and we do draw CSF samples from the pt. and flush the EVD distally.

[night_owl_504]

I have a question... I am normally a cardiac nurse but I had the lovely pleasure of getting a pt with an EVD. I'm not really sure which type it was but it is made by medtronic and is by gravity. My question is... If the tubing(not sure correct terminology) proxomial to the pt has blood in it (which was a small amt. And it was a fresh drain) how do you get rid of it? If you turn the stop cock off to the pt and drain and then flush would that do it??? I followed this nurse who said she flushed the line bc it had some blood in the line. I'm just not understanding how in the world she got that blood that was in the tubing right by the insertion site into the drainage bag by "flushing it". Call me stupid... I don't know... I'm just hoping he didn't do what I think he did? I'm hoping to be wrong... Any help would be appreciated.