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Neuromonitoring at the Bedside - Online
Neuromonitoring At The Bedside
Neuromonitoring At The Bedside
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Video Summary
Today's webcast, moderated by Swarna Rajagopalan, a neurointensivist and associate professor at Cooper University Hospital, delved into "Neuromonitoring at the Bedside." The talk emphasized the critical role of neuromonitoring in managing brain-injured patients, aiming to improve patient outcomes by identifying and mitigating secondary brain injuries.<br /><br />The presentation opened with Golda Boahene-Norte, a clinical nurse with over a decade of experience in neurocritical care. She outlined the goals of neuromonitoring, illustrated through a detailed case study of a 44-year-old woman presenting with a subarachnoid hemorrhage and hydrocephalus. Key neuromonitoring tools were highlighted, including the External Ventricular Drain (EVD), which serves to both drain cerebrospinal fluid (CSF) and monitor intracranial pressure (ICP).<br /><br />Golda detailed the setup and proper usage of EVDs, stressing the importance of aseptic techniques to prevent infections and the necessity of regular calibration and leveling to ensure accurate readings. Troubleshooting tips for common issues like high ICP, negative ICP readings, or lack of CSF drainage were provided.<br /><br />The discussion then shifted to intracranial pressure monitoring specifics. Dr. Rajagopalan compared intraventricular and intraparenchymal monitors, outlining their benefits and limitations. The Brain Trauma Foundation's guidelines for ICP monitoring in traumatic brain injury (TBI) patients were discussed, emphasizing the importance of preventing secondary brain injuries such as seizures and edema.<br /><br />Case examples highlighted the critical decision-making needed for selecting the type of ICP monitors. The presentation also covered the implications of ICP waveform morphology and the transition from normal to critical states through waveform analysis. Non-invasive monitoring techniques, like transcranial Dopplers and optic nerve sheath diameter assessment, were touched upon as supplemental tools.<br /><br />The webcast concluded with a detailed Q&A session, addressing practical considerations like antibiotic prophylaxis, patient transport with ICP monitors, and the role of cerebral microdialysis. The recording will be available within five to seven business days on mysccm.org under the "My Learning" tab.
Keywords
neuromonitoring
brain injury
intracranial pressure
External Ventricular Drain
neurocritical care
subarachnoid hemorrhage
aseptic techniques
Brain Trauma Foundation
non-invasive monitoring
cerebral microdialysis
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