Neuromonitoring at the Bedside - Live-Neuromonitoring At The Bedside

Video Transcription

Video Summary

The webcast titled "Neuromonitoring at the Bedside" was moderated by Swarna Rajagopalan, a neurointensivist and associate professor of neurology at Cooper University Hospital and Cooper Neurological Institute in Camden, New Jersey. The session is recorded and will be available on mysccm.org under the My Learning tab.<br /><br />Golda Boahene-Norte, a clinical nurse with significant experience in neurocritical care from Icahn School of Medicine at Mount Sinai, led the main discussion. She covered the significance of neuromonitoring in brain-injured patients, the various monitoring modalities, and identification and usage of external ventricular drains (EVDs).<br /><br />Through a case study of a woman with a subarachnoid hemorrhage and subsequent hydrocephalus, Golda illustrated the application of tools like EVDs for monitoring and treating increased intracranial pressure (ICP). Neuromonitoring helps clinicians prevent further injury by providing critical data through various invasive and non-invasive methods.<br /><br />Golda explained the detailed process of EVD setup, calibration, and utilization. She highlighted the importance of maintaining a sterile environment to prevent infections and underscored typical institutional policies for effective device management. Discussion on troubleshooting EVDs emphasized handling ICP crises and managing CSF drainage accurately.<br /><br />Swarna took over to discuss the broader scope of intracranial pressure monitoring, referring to the Monroe-Kelly Doctrine and the compliance curve. She elaborated on different ICC monitoring approaches, including EVDs and intraparenchymal monitors, and considerations for their usage based on patient conditions. <br /><br />The session concluded with a Q&A, addressing topics such as antibiotic prophylaxis, managing agitated patients with EVDs, non-invasive monitoring techniques, and integrating cerebral microdialysis into practice. Practical advice on patient handling, especially during transfers to imaging suites, was also provided.

Keywords

Neuromonitoring

Neurocritical Care

Intracranial Pressure

External Ventricular Drains

Subarachnoid Hemorrhage

Hydrocephalus

Invasive Monitoring

Non-Invasive Monitoring

Cerebral Microdialysis

Neurointensivist

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