TITLE

Placement of Intracranial Pressure Monitors by Non-Neurosurgeons

AUTHOR(S)
Harris, Caleb H.; Smith, R. Stephen; Helmer, Stephen D.; Gorecki, John P.; Rody, R. Brent
PUB. DATE
September 2002
SOURCE
American Surgeon;Sep2002, Vol. 68 Issue 9, p787
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Maintaining adequate cerebral perfusion is important in the treatment of patients with closed head injury. Placement of an intracranial pressure (ICP) monitor is necessary to determine both ICP and the cerebral perfusion pressure and serves as a guide to the contemporary management of traumatic brain injury. Insertion of such monitoring devices historically has been performed by neurosurgeons, but others including general (trauma) surgeons have successfully inserted simple ICP monitors. The purpose of this study was to assess the efficacy of ICP monitor placement and to compare the complication rates for ICP monitor placement by general surgery residents, trauma surgeons, and staff neurosurgeons. We retrospectively reviewed the medical records of trauma patients with cerebral injury who required insertion of parenchymal ICP monitors from January 1994 to January 1999. Monitor placement was performed by staff neurosurgeons, general surgical residents, and trauma surgeons. Surgical residents received appropriate training in the placement of ICP monitors from attending trauma surgeons and neurosurgeons. Records were examined for demographic variables such as age, gender, mechanism of injury, admission Glasgow Coma Score, and Injury Severity Score. Records were also reviewed for duration of ICP monitoring and for complications (i.e., intracranial hemorrhage after monitor placement, monitor-related infection, monitor malfunction, and monitor displacement). One hundred fifty-seven monitors were placed in 146 patients with intracranial injury. Surgical residents placed 87 ICP monitors without neurosurgical or trauma attending surgeons at the bedside and 43 with immediate supervision by general surgeons or neurosurgeons. Neurosurgeons placed 26 monitors without the participation of residents, and an attending trauma surgeon placed one monitor without the involvement of a resident or a neurosurgeon. There were no major technical complications, no episodes of...
ACCESSION #
7752132

 

Related Articles

  • Treatment and outcomes for pediatric head injuries in Mississippi. Hanigan, William; Giurintano, Christina; Hallstrom, Craig; Spinosa, Frances; Esposito, Domenic; Parent, Andrew; May, Warren // Child's Nervous System;Apr2011, Vol. 27 Issue 4, p583 

    Object: This report summarizes the treatments and outcomes of a large series of patients with pediatric head injuries (PHIs), who were admitted to a tertiary pediatric trauma center at the University of Mississippi Medical Center from January 1, 2003 through December 31, 2006. Methods: Data were...

  • Urban Trauma Centers: Not Quite Dead Yet. Patton Jr., Joe H.; Woodward, Ann M. // American Surgeon;Apr2002, Vol. 68 Issue 4, p318 

    With decreasing violent crime and an increase in the use of nonoperative management techniques the viability of urban trauma centers has come into question. In addition the workload and productivity for surgeons at such centers may be threatened. The current study examines the changing...

  • `Adult' trauma surgeons with pediatric commitment: A logical solution to the pediatric trauma... D'Amelio, L.F.; Hammond, J.S. // American Surgeon;Nov1995, Vol. 61 Issue 11, p968 

    Investigates the possibility of using adult surgeons in pediatric trauma care as a solution to manpower shortage. Annual ratio of injured patient for every pediatric surgeon; Experimental procedure; Use of nonoperative protocols for solid organ injury; Application of Major Trauma Outcome Study...

  • Experts call for pituitary 'centers of excellence'. Adams, Stacey L.; Calabro, Anthony; Costa, Samantha; Shafer, Emily; Taliercio, Adam // Endocrine Today;Jan2013, Vol. 11 Issue 1, p24 

    The article reports on the call by researchers for recognizing pituitary centers of excellence designation at hospitals and suggest a voluntary verification process, similar to that used by the American College of Surgeons for Trauma Center Verification.

  • Impact of orthopedic trauma consolidation on resident education. Martins, Sandrew; Johnston, Geoffrey // Canadian Journal of Surgery;Dec2009, Vol. 52 Issue 6, p495 

    Background: In July 2005, the Saskatoon Health Region, in conjunction with its orthopedic surgeons, consolidated its management of orthopedic emergencies from 3 sites to 1, resulting in trauma patients being directed to the university hospital site (Royal University Hospital; RUH) where...

  • Guidelines for aute medical management of severe traumatic brain injury in infants and children. Khilnani, Praveen // Indian Journal of Critical Care Medicine;Oct-Dec2003, Vol. 7 Issue 4, p285 

    Presents a summary of the guidelines for the acute medical management of severe traumatic brain injury in infants, children and adolescents. Treatment of pediatric patients with traumatic brain injury in a pediatric trauma center; Medication of hypoxia; Indication of intracranial pressure...

  • Intensive care management of head injury patients without routine intracranial pressure monitoring. Santhanam, R.; Pillai, Shibu V.; Kolluri, Sastry V. R.; Rao, U. M. // Neurology India;Oct-Dec2007, Vol. 55 Issue 4, p349 

    Background: Head injury contributes significantly to mortality and morbidity in India. Evaluation of the available trauma care facilities may help improve outcome.Aim: To evaluate the factors influencing the mortality of patients with head injury who had intensive care...

  • Do you follow guidelines for traumatic brain injury?  // ED Nursing;Apr2008, Vol. 11 Issue 6, p68 

    Compliance with guidelines for severe traumatic brain injury is increasing at trauma centers, says a new study. However, compliance at community EDs is likely to be poorer, and if this condition is not managed correctly, severe adverse outcomes can occur. • Perform appropriate...

  • Admission of patients with severe and moderate traumatic brain injury to specialized ICU facilities: a search for triage criteria. Hukkelhoven, Chantal W. P. M.; Steyerberg, Ewout W.; Habbema, J. Dik F.; Maas, Andrew I. R. // Intensive Care Medicine;Jun2005, Vol. 31 Issue 6, p799 

    Objective: To investigate whether triage for direct admission of patients with traumatic brain injury to a trauma center is facilitated by predicting the risk of potentially removable lesions or raised intracranial pressure (ICP).Design and Setting: Cohort study in a...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics