Nurses may prime and connect the intraventricular drainage system in CCTC. All CSF draining catheters (intraventricular; lumbar ICP) must be connected to the CodmanTM External Drainage System for safety.
This procedure refers to the measurement of intracranial pressure through an external ventricular drainage catheter (EVD) using a standard fluid filled pressure transducer.
2. Single pressure transducer circuit primed with normal saline and connected to the patient stopcock stopcock closest to patient catheter (as per setup of drainage system)
3. Transducer pressure cable connected to bedside monitor and "ICP" selected as pressure monitoring mode. If ICP is greater than 20 mmHg, the scale will need to be increased.
4. "0" reference on Codman EDS 3TM drainage unit panel has been leveled using a laser level (in CN cupboard)
Tape the transducer to the back of the CodmanTM drainage unit. Position the transducer so that the stopcock that is located above the transducer is level with the "0" marking on the Codman EDS 3TM drainage collection panel.
Taping the transducer into position will ensure that leveling of both the drainage collecting unit and pressure monitoring system can be accomplished each time the Codman EDS 3TM drainage unit is re-leveled. Leveling the drainage chamber ensures that CSF drainage will occur according to the prescribed pressure.
Note that drainage of CSF occurs when the pressure in the cranial compartment exceeds the level (in cmH20) of the drainage collecting chamber. The catheter must also be patent and there must be CSF in the ventricle for drainage to occur.
The bedside monitor will display the ICP in mmHg, but the drainage position is ordered in cmH20. The Codman drainage collection unit identifies drain levels in both cmH20 and mmHg to demonstrate equivalent readings.
For example, if the drain is set to a level of 10 cmH20, a drainage gradient occurs if the pressure in the head is greater than 10 cmH20 or 7.4 mmHg (equivalent bedside pressure).
Turn laser level on while positioned in laser holder on Codman EDS 3TM drainage collection system. Adjust panel until the laser beam is directed into external auditory canal.
Perform hand hygiene
Ensure stopcock located above transducer is level with "0" on Codman EDS 3TM panel and patient's tragus
Remove the Luer-lock cap on the stopcock
Turn the stopcock "off" toward the patient monitoring tubing (hard non-compliant tubing)
Press "zero" on the bedside pressure monitoring module
Confirm that the pressure waveform displayed is resting on the "zero" line of the pressure display
Turn stopcock back to monitoring position
Replace cap with non-vented luer lock cap
Reconfirm level with each pressure measurement
In IView, select the Adult ICU Lines - Devices Navigation Band. If you do not have Intracranial/Lumbar Monitor and Drain as an option, select it from custom view. Select the Intracranial/Lumbar drain type and create a Dynamic Group. Record Pressures and Hourly Output.
Created: November 1988
Last Update: February 1, 2020; Reviewed February 4, 2021; Revised January 30, 2023