iCP Monitoring

iCP Monitoring
What is intra-cranial pressure monitoring?
What is the ICP?
What is the “Modified Monro-Kellie Doctrine”?
Why does ICP rise or fall?
What is the normal range for ICP?
Why is elevated ICP so bad?
What does a patient look like when she has a rising ICP?
A story that illustrates the point.
What is the CPP?
What is the CCCP?
How is ICP measured?
What is a “bolt”?
ventriculostomy
subarachnoid screw
fiberoptic monitors
epidural sensors
noninvasive ICP monitoring
How long can a bolt stay in?
How do I take care of a bolt?
ventriculostomies
levelling
the foramen of Monro
drainage
subarachnoid bolts
the fiberoptic cable
What is a bolt waveform supposed to look like?
What is it not supposed to look like?
What if the waveform is dampened, or goes away?
How is a high ICP treated?
Drainage
Positioning and treatments: do’s and don’ts
Hyperventilation, or not
Mannitol – “drying out the brain”
A Very Important Point!
Steroids
Anticonvulsants
Barbiturarte “coma”
Other sedatives
Cooling
Oxygenation
Hypertensive therapy
This one is definitely a little different. This time the preceptor really has only the most basic idea of what is going on, since we see these things only once or twice in a year. So this time the project involved going out into the field, looking around, writing stuff down, and coming back to tell the rest of the tribe what I saw. So - please correct things in this file that are not the way they should be. This is serious stuff, as always, and we need to get it right every time. Do not use this article as a primary reference or substitute for in-house training on this subject! If one of these devices should show up, call the neuro ICU RNs; they are always happy to come down, inspect the setup, and give advice.
References: We’re getting better at this – wherever possible we’re including website sources as embedded hyperlinks in the text. If you’re reading this text on a machine that’s hooked up to the web, clicking the blue link should take you to the site that we got the material from.