Cerebrospinal Fluid Drainage Management
Cerebrospinal fluid (CSF) drainage aims to reduce CSF pressure to the desired level and then to maintain it at that level. Fluid can be withdrawn from the lateral ventricle (ventriculostomy) or the lumbar subarachnoid space, depending on the indication and the desired outcome, via a catheter and a closed-drainage collection system. Ventricular drainage is used to reduce increased intracranial pressure (ICP); lumbar drainage—a type of external drainage—is used to help heal the dura mater. External CSF drainage is used most commonly to manage increased ICP and facilitate spinal or cerebral dural healing after traumatic injury or surgery.
Other therapeutic uses of CSF drainage include ICP monitoring via the ventriculostomy; direct instillation of medications, contrast media, or air for diagnostic radiology; and aspiration of CSF for laboratory analysis. (See CSF drainage, page 152.)
This procedure focuses on ventricular drainage management.
External drainage set (includes drainage tubing and sterile collection bag) ▪ gloves ▪ suture material ▪ 4″ × 4″ sterile dressings ▪ paper tape ▪ IV pole.
Preparation of Equipment
After the doctor places the catheter, connect it to the external drainage system tubing. Secure connection points with tape or a connector. Place the collection system, including drip chamber and collection bag, on an IV pole.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Explain the procedure to the patient and his family.
Perform a baseline neurologic assessment, including vital signs.
Ensure that the flow chamber of the ICP monitoring setup remains positioned as ordered. You should also correlate changes in ICP to the drainage.
Trace the tubing back to its point of origin to make sure you’re accessing the correct tubing.
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