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2015 ; 6
(Suppl 6
): S271-4
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External ventricular drains: Management and complications
#MMPMID26069848
Muralidharan R
Surg Neurol Int
2015[]; 6
(Suppl 6
): S271-4
PMID26069848
show ga
BACKGROUND: Insertion of an External Ventricular Drain (EVD) is arguably one of
the most common and important lifesaving procedures in neurologic intensive care
unit. Various forms of acute brain injury benefit from the continuous
intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) diversion
provided by an EVD. After insertion, EVD monitoring, maintenance and
troubleshooting essentially become a nursing responsibility. METHODS: Articles
pertaining to EVD placement, management, and complications were identified from
PubMed electronic database. RESULTS: Typically placed at the bedside by a
neurosurgeon or neurointensivist using surface landmarks under emergent
conditions, this procedure has the ability to drain blood and CSF to mitigate
intracranial hypertension, continuously monitor intracranial pressure, and
instill medications. Nursing should ensure proper zeroing, placement, sterility,
and integrity of the EVD collecting system. ICP waveform analysis and close
monitoring of CSF drainage are extremely important and can affect clinical
outcomes of patients. In some institutions, nursing may also be responsible for
CSF sampling and catheter irrigation. CONCLUSION: Maintenance, troubleshooting,
and monitoring for EVD associated complications has essentially become a nursing
responsibility. Accurate and accountable nursing care may have the ability to
portend better outcomes in patients requiring CSF drainage.