FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4236091891> ?p ?o ?g. }

• W4236091891 endingPage "59" @default.
• W4236091891 startingPage "57" @default.
• W4236091891 abstract "Q Our policy on external ventricular drainage (EVD) systems includes the procedure for priming the system. However, when we insert an EVD in our unit, as well as in the operating room, our surgeons do not want the system primed. American Association of Critical-Care Nurses guidelines, as well as many of the company inserts, state that the system should be primed. Does it really have to be primed?A Linda R. Littlejohns, rn, msn, ccrn, cnrn, and Brett Trimble, bsme, reply:EVD systems have been in use since 1951, when continuous measurement of intracranial pressure (ICP) with an inductance manometer was first reported by Guillaume and Janny.1 Many investigators confirmed this early research into the utility of the fluid-filled manometer and strain gauge transducer to measure ICP.2 In 1965, Lundberg et al3 discussed the value that was added to patient management interventions when the ICP could be measured, documented, and treated, building on the work done by Fay,4 who described the value of ventricular drainage in patient management.5Today, the use of extraventricular drainage is common in the management of severe traumatic brain injury, subarachnoid hemorrhage, tumors, central nervous system infections, and acute shunt or ventricular obstruction. Practice has not changed much over the decades in the management of ventricular drainage systems. Using aseptic technique, a catheter is introduced into the anterior horn of the nondominant ventricle through a burr hole and then tunneled under the scalp. In some instances, the ventricular catheter is placed using a bolted system and miniaturized transducer within the catheter. In all cases, the ventricular catheter is connected to a cerebrospinal fluid (CSF) collection system comprising tubing, a burette, and a collection bag.6The question of priming the CSF collection system is an area that is often neglected at the bedside when the emphasis is placed on the numeric values for ICP management.7,8 Unfortunately, priming the system or not can have quite an impact on the amount and speed at which CSF drains from the patient. We must review not only our nursing and medical research, but also the engineering tenets that govern the behavior of fluids and gases and their compressibility in a confined space.The pressure at which CSF drainage will begin is controlled by positioning the point where the connecting tubing of the EVD empties into a burette, drip chamber, or collection bag relative to the ventricular catheter tip at Monro’s foramen. The external landmarks of Monro’s foramen are the midpoint between the outer canthus of the eye and the tragus of the ear or external auditory canal, and nurses customarily “level” their drainage system to this point. The collection system is usually set at a prescribed height based on the desired upper limit for controlling the ICP. When the ICP exceeds the set level, CSF will drain into the collection system. Leveling works because the ICP must overcome the static fluid column pressure exerted by the weight of the CSF or fluid in the tubing before drainage can occur.9–11This phenomenon is based on the basic law of hydrostatic s. Fluid column pressure is often expressed in height units of a particular fluid such as centimeters of water (cm H2O) and can be calculated as, “pressure = ρgh,” where ρ (density of fluid), g (gravitational force), and h (height of column)11 refer to the vertical distance between the tip of the ventricular catheter and the point at which the fluid meets atmospheric pressure.In an unprimed EVD system, the point at which the CSF in the connecting tubing meets the atmospheric pressure will vary as the tube fills with CSF. Because the tubing may be draped off the end of the bed or above the level of the head, there is random gravity pressure exerted on the column in the tubing, which may be greater or less than that of a full fluid column. Translated into practice, this means that the flow of CSF will be faster and in a greater quantity when the unprimed tubing hangs down and will meet greater resistance when traveling upward toward the burette in unprimed tubing.If the tubing is not primed, we also run the risk of fluid partly filling the tubing and capturing air bubbles, which further alter the flow of fluid to the collection bag.Liquids such as CSF transmit pressure efficiently because they are much denser than gases such as air. For example, a 10-fold increase in the pressure exerted on a liquid will result in a density change of the liquid of less than 1%. A similar change in pressure exerted on a gas (at constant temperature conditions) can result in a density change of 400%.12 Therefore, liquids are usually assumed to be incompressible whereas gases are assumed to behave according the “perfect gas law,” PV=nRT, where pressure times volume of a gas equals the number of moles of the gas times the “gas constant” times temperature.If the clinician is using an external transducer for measuring and recording ICP, air bubbles in the connecting tubing of an EVD system lead to dampened waveforms and inaccurate pressure measurements for the reasons stated above. Manufacturers of drainage systems suggest priming the system, using aseptic technique and preservative free isotonic sodium chloride solution before attaching the system to the ventricular catheter and the patient.12 Severely brain-injured patients require impeccable attention to detail throughout their hospitalization to optimize their outcomes, and priming the tubing of the drainage system is one small aspect that can make a difference to the management of this fragile population." @default.
• W4236091891 created "2022-05-12" @default.
• W4236091891 creator A5029207856 @default.
• W4236091891 creator A5086354966 @default.
• W4236091891 date "2005-06-01" @default.
• W4236091891 modified "2023-09-26" @default.
• W4236091891 title "Ask the Experts" @default.
• W4236091891 cites W1643639871 @default.
• W4236091891 cites W1979662751 @default.
• W4236091891 cites W1994052527 @default.
• W4236091891 cites W1996927922 @default.
• W4236091891 cites W2009676082 @default.
• W4236091891 cites W2051155299 @default.
• W4236091891 cites W2059549353 @default.
• W4236091891 cites W2256277875 @default.
• W4236091891 doi "https://doi.org/10.4037/ccn2005.25.3.57" @default.
• W4236091891 hasPublicationYear "2005" @default.
• W4236091891 type Work @default.
• W4236091891 citedByCount "2" @default.
• W4236091891 countsByYear W42360918912012 @default.
• W4236091891 countsByYear W42360918912019 @default.
• W4236091891 crossrefType "journal-article" @default.
• W4236091891 hasAuthorship W4236091891A5029207856 @default.
• W4236091891 hasAuthorship W4236091891A5086354966 @default.
• W4236091891 hasConcept C118552586 @default.
• W4236091891 hasConcept C141071460 @default.
• W4236091891 hasConcept C164705383 @default.
• W4236091891 hasConcept C2777996791 @default.
• W4236091891 hasConcept C2778134817 @default.
• W4236091891 hasConcept C2778921608 @default.
• W4236091891 hasConcept C2780954326 @default.
• W4236091891 hasConcept C2781017439 @default.
• W4236091891 hasConcept C2781223406 @default.
• W4236091891 hasConcept C2781267111 @default.
• W4236091891 hasConcept C71924100 @default.
• W4236091891 hasConceptScore W4236091891C118552586 @default.
• W4236091891 hasConceptScore W4236091891C141071460 @default.
• W4236091891 hasConceptScore W4236091891C164705383 @default.
• W4236091891 hasConceptScore W4236091891C2777996791 @default.
• W4236091891 hasConceptScore W4236091891C2778134817 @default.
• W4236091891 hasConceptScore W4236091891C2778921608 @default.
• W4236091891 hasConceptScore W4236091891C2780954326 @default.
• W4236091891 hasConceptScore W4236091891C2781017439 @default.
• W4236091891 hasConceptScore W4236091891C2781223406 @default.
• W4236091891 hasConceptScore W4236091891C2781267111 @default.
• W4236091891 hasConceptScore W4236091891C71924100 @default.
• W4236091891 hasIssue "3" @default.
• W4236091891 hasLocation W42360918911 @default.
• W4236091891 hasOpenAccess W4236091891 @default.
• W4236091891 hasPrimaryLocation W42360918911 @default.
• W4236091891 hasRelatedWork W18946173 @default.
• W4236091891 hasRelatedWork W1986915943 @default.
• W4236091891 hasRelatedWork W2003938723 @default.
• W4236091891 hasRelatedWork W2047967234 @default.
• W4236091891 hasRelatedWork W2118496982 @default.
• W4236091891 hasRelatedWork W2364998975 @default.
• W4236091891 hasRelatedWork W2375521748 @default.
• W4236091891 hasRelatedWork W2439875401 @default.
• W4236091891 hasRelatedWork W4238867864 @default.
• W4236091891 hasRelatedWork W2525756941 @default.
• W4236091891 hasVolume "25" @default.
• W4236091891 isParatext "false" @default.
• W4236091891 isRetracted "false" @default.
• W4236091891 workType "article" @default.