Spinal drains in thoracoabdominal aneurysm surgery

[nmsumurse]

Ever since we've started performing these surgeries at my shop, the spinal drains have been extremely problematic. Anesthesia places them in OR, but then neurosurg gets involved because of the spinal drain and claims all spinal drains in the ICU's are theirs. So because of this leveling has been extremely problematic. Our protocol for the TAAA surguries has them at the 4th ICS mid axillallary line. Neurosurg wants them and attempts to bully nurses into changing it to foramen of monro. How is this handled at your facility, hoping to accumulate evidence and other protocols to get neurosurg to butt out of the process.

[Rose_Queen, BSN, MSN, RN]

Our spinal drains are placed by a neurosurgeon. Anesthesia doesn't touch them at all- we even have a neuro ICU nurse come down to the OR to connect them for monitoring and drainage.

[Sun0408, ASN, RN]

All of our drains are placed by neuro. Anastasia only places and maintains epidurals for pain control.

[Sun0408, ASN, RN]

Lol. Sorry about the misspelling. Da$n autocorrect 😂

[MunoRN, RN]

That doesn't make any sense since the definition of the zero level is where the tip of the drainage catheter is. I'm not sure how I would respond to someone that thought we should be using the ventricles as the zero level for a lumbar drain, I guess I would start by asking if we have the same understanding of where the drain is located and how hydrostatic pressure works and how the we adjust the level compared to the drain location to determine drainage pressure.

[nmsumurse]

Yes that was my argument as well muno. It looks like our neurosurg residents are not going anywhere though when it comes to these drains though, and they're not willing to listen to the bedside rn nor our educators in the surgical icu.

[dexm]

Our spinal drains are placed by anesthesia or neurosurg in OR and managed by vascular surgery post-op. We also level and zero at 4th ICS midaxillary line per our protocol.