Urgent: In over my head...ICP Monitoring

Specialties Neuro

Published

I chose the topic of external intracranial monitoring and drainage devices as a teaching topic for my PN teaching project. I'm way over my head. I've spent hours trying to understand the nurses responsibility and how and why she levels, zero's out, .....I'm in over my head. I need this in Dummies terms. I am writing a 5 page paper and am to give a 10 minute presentation....Please have mercy and help me...BTW...icufaqs.com: icp monitoring was over my head too.

Specializes in ICU, and IR.

Take a look at youtube there are some great videos of placement of EVDs. Most things have been said already basically number one is make sure it doesn't get pulled out. X-ray and lab and the patient themselves often don't pay attention to the drain. It not very innervated so there isn't much sensation to placement or having it in after. We also check output Q1 hour most docs like about 10-15 mls an hour but it can be more. Check color it will be bloody in the beginning but should turn clear after that. Check ICP on the monitor if it starts rising you need to call the MD. Things that can cause a rise: Pressure, movement of the drain to where it isn't level with the axis, Pt having a BM, coughing, things like that. When you start to move the patient you close the drain to prevent it from draining too much at once, afterwards you level it again. Emergency measures for high ICP is often mannitol (Diuretic) or what we call salt bombs which is 21% NACL the salt draws fluid. I hope that helps with your project.

The link you shared is broken, may you provide another resource? Thank you :)

I work on a Neuro-ICU floor. We deal a lot with ICP and Ventrics. Our responsibilities with Ventrics include: assess the patency of the device, leveling to whatever the neurosurgeon has ordered, assess the amount and color of CSF, and patient's tolerance. As for ICPs, -monitor trend and intervene (sedation and pain-management, pressors, 3% NACL, mannitols, and temp regulation). And make sure those devices don't get pulled out!!!

Majority of the time these patients are being ventilated?

Majority of the time these patients are being ventilated?

The patient will only be ventilated if their GCS is 8 or less or airway protection OR they are so erratic that they are a danger to themselves and are preventing safe ICP / CSF management and require sedation that may interrupt their ability to protect their airway. Most of my SAH EVD patients are NOT intubated.

Thank you, lotus81... Can definitely lead to death if patient is not ready. Typical duration for an EVD is 10 days.

+ Add a Comment