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Zero-Calibrating External Ventricular Drains: Exploring Practice.

Karen A Pratt, Sarah H Peacock, Kaylie D Yost

    The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
    |December 9, 2021
    PubMed
    Summary
    This summary is machine-generated.

    Zero-calibrating external ventricular drains (EVDs) without removing the nonvented cap (NVC) is as effective as the traditional method. This finding supports updated institutional guidelines for safer EVD management.

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    Area of Science:

    • Neurosurgery
    • Critical Care Medicine
    • Nursing Practice

    Background:

    • Current guidelines recommend removing the nonvented cap (NVC) during external ventricular drain (EVD) zero-calibration.
    • Some institutions have ceased NVC removal to minimize system contamination.
    • Evidence comparing EVD zero-calibration methods is lacking.

    Purpose of the Study:

    • To evaluate the safety and efficacy of different EVD zero-calibration techniques.
    • To compare intracranial pressure (ICP) readings with and without NVC removal during EVD zeroing.

    Main Methods:

    • A multidisciplinary team utilized reflective practice to assess EVD zero-calibration procedures.
    • A bedside trial compared ICP measurements under three conditions: tidal ICP, zeroing with NVC removal, and zeroing without NVC removal.

    Main Results:

    • Existing clinical guidelines and manufacturer recommendations for EVD zero-calibration were found to be outdated and fragmented.
    • The bedside trial demonstrated equivalent ICP readings across all tested zero-calibration methods.
    • No significant difference in ICP measurements was observed when zeroing the EVD with or without NVC removal.

    Conclusions:

    • Institutional guidelines were revised to permit EVD zero-calibration without NVC removal for compatible systems.
    • This updated practice aims to enhance system safety by preventing air introduction.
    • Further research is recommended to establish definitive best practices for EVD zero-calibration.