External ventricular drains: Management and complications

Area of Science:

• Neurosurgery
• Neurology
• Critical Care Nursing

Background:

• External Ventricular Drain (EVD) insertion is a common, life-saving procedure in neurologic intensive care.
• EVDs are essential for intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) diversion in acute brain injuries.
• Post-insertion, EVD management, including monitoring and troubleshooting, becomes a primary nursing responsibility.

Purpose of the Study:

• To review the management and nursing responsibilities associated with External Ventricular Drains (EVDs).
• To highlight the importance of nursing care in optimizing outcomes for patients with EVDs.

Main Methods:

• A literature search was conducted using the PubMed electronic database.
• Articles focusing on EVD placement, management, and complications were identified.

Main Results:

• EVDs are typically placed emergently at the bedside to manage intracranial hypertension by draining blood and CSF, monitor ICP, and administer medications.
• Nurses are responsible for ensuring correct EVD system setup, including proper zeroing, placement, sterility, and integrity.
• Close monitoring of ICP waveforms and CSF drainage by nurses is critical for patient outcomes; some institutions also assign CSF sampling and catheter irrigation to nursing staff.

Conclusions:

• EVD maintenance, troubleshooting, and complication monitoring are integral nursing duties.
• Accurate and diligent nursing care in managing EVDs can lead to improved patient outcomes.