Protocols for External Ventricular Drains
Three distinct purposes exist for the placement of an external ventricular drain like Traumatic brain injury, hydrocephalus and Intra ventricular hemorrhage.
- Commonest site chosen for Burr hole is right frontal region.
- All patients EVD is done at the Operating room only.
- The drainage level will be set and adjust by the Neurosurgeons.
- Proper antibiotics administered.
- Changes in the threshold for drainage are made after consultation with the neurosurgeons.
- Minimum time limit for an EVD is 3-5 days.
- More prolonged drainage would be implemented by the Neurosurgeons.
- Routine CSF sampling for infection surveillance is not performed.
- CSF specimens are to be sent as part a fever workup or 2-3 days prior to planned-shunt placement.
- CSF samples sent to evaluate for infection include the following: glucose, protein, lactate, cell count, grams state and culture.
- In patient for whom there is concern for possible CSF infection a CSF sample should be obtained prior to removal of the ventricular catheter.