Question About Ventriculostomies

We've been having a debate at work on setting up the ventriculostomy with the external transducer to measure the ICP. We're a small hospital and don't get many ventriculostomies, but we've had several lately. On one we were told not to inflate the pressure bag on the external transducer because with it inflated it gives a continuous flush of approximately 3 cc/hr. I completely took the pressure bag off so that it would not be accidently inflated. The next one we get, we're told to inflate the pressure bag because it won't transduce if it's not inflated. Some say you can do that as long as you roller clamp it off so that they won't get the flush, others say leave it open and it won't flush anything if the pigtail isn't pulled. Also, if you're going to clamp it off what's the point of the pressure bag? I was just wondering what some of you neuro ICU nurses say since you probably deal with these a lot more often than we do. I hope my question makes sense.
I'm confused. On what exactly are you putting the pressure bag? I've never hooked a bag of anything to a ventriculostomy.

Preservative free normal saline solution...

we use a 20cc syringe filled with preservative free NS attached to the top of our transducer

Quote from LegzRNPreservative free normal saline solution...

Quote from countrygirl88On one we were told not to inflate the pressure bag on the external transducer because with it inflated it gives a continuous flush of approximately 3 cc/hr. The next one we get, we're told to inflate the pressure bag because it won't transduce if it's not inflated. Some say you can do that as long as you roller clamp it off so that they won't get the flush, others say leave it open and it won't flush anything if the pigtail isn't pulled.

I work neuro ICU and we NEVER put a pressure bag on a transducer for an EVD (external ventriculostomy drain) and don't put a syringe on the transducer either. We use the ones made by integra and use a transducer with out a pigtail. NEVER EVER flush one toward the patient ONLY AWAY from the patient.

You should not have anything attached to the transducer and defiantly it should not be on a pressure bag. The whole point of putting in a ventric rather than a camino is so the fluid can drain from the head. Instead you are putting fluid into the brain, a high risk source of infection and causing an increase in pressure. As nrsang97 said, your transducers should not have pigtails on them. If you don't have the correct supplies because you are a small hospital please talk to the doctors about transfer those pt's to a higher level of care, so they can be treated correctly. I am surprised that your neurosurgeons have not corrected this practice before now. Please look up the policy and if you don't have one, then go to your educator about this.

Quote from countrygirl88We've been having a debate at work on setting up the ventriculostomy with the external transducer to measure the ICP. We're a small hospital and don't get many ventriculostomies, but we've had several lately. On one we were told not to inflate the pressure bag on the external transducer because with it inflated it gives a continuous flush of approximately 3 cc/hr. I completely took the pressure bag off so that it would not be accidently inflated. The next one we get, we're told to inflate the pressure bag because it won't transduce if it's not inflated. Some say you can do that as long as you roller clamp it off so that they won't get the flush, others say leave it open and it won't flush anything if the pigtail isn't pulled. Also, if you're going to clamp it off what's the point of the pressure bag? I was just wondering what some of you neuro ICU nurses say since you probably deal with these a lot more often than we do. I hope my question makes sense.

OMG!!! Pllllleeease tell me you are confusing an ARTERIAL LINE pressure bag transducer system with a ventriculostomy transducer system??! I work in a neurovascular/surgical ICU and a pressure bag should NEVER be NEAR a ventriculostomy. We use the same TUBING for an EVD, it is primed before attaching it to the patient and that's it. No syringe or pressure bag. That's for an arterial line transducer system only. If a ventric ever needs to be flushed, only done so legally per hospital policy by an MD ONLY.

Quote from mooremdsWe've been having a debate at work on setting up the ventriculostomy with the external transducer to measure the ICP. We're a small hospital and don't get many ventriculostomies, but we've had several lately. On one we were told not to inflate the pressure bag on the external transducer because with it inflated it gives a continuous flush of approximately 3 cc/hr. I completely took the pressure bag off so that it would not be accidently inflated. The next one we get, we're told to inflate the pressure bag because it won't transduce if it's not inflated. Some say you can do that as long as you roller clamp it off so that they won't get the flush, others say leave it open and it won't flush anything if the pigtail isn't pulled. Also, if you're going to clamp it off what's the point of the pressure bag? I was just wondering what some of you neuro ICU nurses say since you probably deal with these a lot more often than we do. I hope my question makes sense.