Identify the slide clamp on either side of the CSF sampling port
Clamp the slide clamp that is located between the CSF sampling port and the drainage collecting chamber.
Maintain the clamp for 5-10 minutes only. Monitor the ICP while clamped. If the ICP increases and exceeds the ICP target, collect the sample and reopen the clamp.
Clamping the catheter allows the ventricle to fill with CSF prior to sampling. This increases the ability to obtain a specimen and may decrease the risk of generating a negative pressure within the ventricle.
Prepare the sampling port
Open chlorhexidine/alcohol swab stick package
With your non-dominant hand, lift the tubing near the CSF sampling port off the bed.
Open up the green towel to create a sterile field.
Scrub the red CSF sampling port hub vigorously with chlorhexidine/alcohol, then scrub the remainder of the red cap. Turn the swab stick over and clean the tubing from the sampling port to the slide clamp.
Place the cleaned tubing onto the sterile field, ensuring the sampling port is completely dry and is protected from any contact.
Collect sample 5 - 10 minutes after clamping as follows (or earlier if ICP increases above target):
Connect a syringe to the luer-lock connection of the red CSF sampling port
With clamp on, gently attempt to aspirate CSF. .
If CSF does not flow easily into the syringe, open the clamp and reattempt aspiration.
Obtain 1 - 2 ml of CSF.
Empty the syringe into an orange sterile speciment container. The lab will not accept specimens in syringes due to risk for spillage/exposure of body fluids.
Verity patient ID and label specimen at bedside.
Ensure that the slide clamp is completely reopened.
Reassess ICP and ICP waveform.
Ensure sample goes to lab STAT.
Document completion and patient response in the clinical record..
August 17, 2006
Last Update: January 31, 2020; Reviewed: February 4, 2021; Reviewed January 21, 2022
AANN (2011). Care of the Patient Undergoing ICP/EVD or LD. AACN. Retrieved from (January 31, 2020): https://www.bmc.org/sites/default/files/Patient_Care/Specialty_Care/Stroke_and_Cerebrovascular_Center/Medical_Professionals/Protocols/AANN%20Guideline%20caring%20for%20ICP%20Monitor%20External%20Vent%20Drain%20or%20Lumbar%20Drainage.pdf