Intracranial Pressure Monitoring

Intracranial Pressure Monitoring

Intracranial pressure (ICP) monitoring measures pressure exerted by the brain, blood, and cerebrospinal fluid (CSF) against the inside of the skull. Indications for monitoring ICP include head trauma with bleeding or edema, overproduction or insufficient absorption of CSF, cerebral hemorrhage, and space-occupying brain lesions. ICP monitoring can detect elevated ICP early, before clinical danger signs develop.1 Prompt intervention can then help avert or diminish neurologic damage caused by cerebral hypoxia and shifts of brain mass.

The four basic ICP monitoring systems are intraventricular catheter, subarachnoid bolt, epidural or subdural sensor, and intraparenchymal pressure monitoring. (See Understanding ICP monitoring, pages 404 and 405.) Regardless of which system is used, the procedure is typically performed by a neurosurgeon in the operating room, emergency department, or intensive care unit. Insertion of an ICP monitoring device requires sterile technique to reduce the risk of central nervous system (CNS) infection. Setting up equipment for the monitoring systems also requires strict asepsis.1

Preparation of Equipment

Various types of preassembled ICP monitoring units are available, each with its own setup protocols. These units are designed to reduce the risk of infection by eliminating the need for multiple stopcocks, manometers, and transducer dome assemblies. When preparing the equipment, label all medications, medication containers, and other solutions on and off the sterile field.2 Some facilities use units that have miniaturized transducers rather than transducer domes.

Monitoring units and setup protocols are varied and complex and differ among health care facilities. Check your facility’s guidelines for your particular unit.

Jul 21, 2016 | Posted by in NURSING | Comments Off on Intracranial Pressure Monitoring
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