Patient Care Technicians in Neuro

Elenaster · Feb 24, 2004

How do PCT's bathe and change bed linens for Neuro pt's? If increasing ICP is a problem are they allowed to change linens and give baths? I was just wondering how this is done.

Perfectly good question Dustin, and really it just depends on the patient. Some neuro patients do not have unstable ICP, but have other issues that keep them in the ICU, such as vasospasm after an aneurysm clipping, craniotomies for tumor or temporal lobe removal, etc. In these types of patients, we do our bed baths and change linens just like you would in any other critically or seriously ill patient. If they have a drain, you simply have the nurse clamp it prior to turning the patient and make sure that it is re-leveled when activities are complete.

However, on rare occasions, there are patients who are so unstable that we may go days without turning or bathing them and in that case we simply chart "too unstable to turn/bathe." These patients generally have a poor prognosis and are in serious danger of brain herniation. They are usually paralyzed and sedated, or in the worst cases, placed in a barbituate coma. We can "spruce up" their fronts if they can tolerate the stimulation, but often times it's best just to leave them alone as much as possible until their ICP stabilizes.

Neuro nurses in general do not like to avoid bathing their patients if at all possible. Every unit I've ever worked in, the nursing staff purchases good-smelling soaps and lotions to bathe the patients with. We call it the "neuro spa."

nurse lucky · Mar 5, 2004

Perfectly good question Dustin, and really it just depends on the patient. Some neuro patients do not have unstable ICP, but have other issues that keep them in the ICU, such as vasospasm after and aneurysm clipping, craniotomies for tumor or temporal lobe removal, etc. In these types of patients, we do out bed baths and change linens just like you would in any other critically or seriously ill patient. If they have a drain, you simply have the nurse clamp it prior to turning the patient and make sure that it is re-leveled when activities are complete.
However, on rare occasions, there are patients who are so unstable that we may go days without turning or bathing them and in that case we simply chart "too unstable to turn/bathe." These patients generally have a poor prognosis and are in serious danger of brain herniation. They are usually paralyzed and sedated, or in the worst cases, placed in a barbituate coma. We can "spruce up" their fronts if they can tolerate the stimulation, but often times it's best just to leave them alone as much as possible until their ICP stabilizes.
Neuro nurses in general do not like to avoid bathing their patients if at all possible. Every unit I've ever worked in, the nursing staff purchases good-smelling soaps and lotions to bathe the patients with. We call it the "neuro spa."

We are not lucky enough to be allowed to use good smelling soaps as it stimulates the brains too much for our neurosurgeons. The yeasty funk is fine with them, unfortunately. I only let techs/aides bathe the front and no head lowering without an RN. I'm responsible for the drain and it's gonna stay in on my watch!

sumrluvr73 · Mar 10, 2004

I agree with you about the drain and responsibility, no one touches my pt for any reason unless I am in the room and supervising, sometimes if the pt can tolerate the frontal stimulation and smells really funky we use shaving cream to bathe them, really helps with the funk and no perfumy smell afterwards