EVD Drain Placement, Nursing Care, MRI Safety, Settings, ICD-10

A Medical device referred to as an External Ventricular Drain (EVD drain) is employed for the purpose of regulating the levels of cerebrospinal fluid (CSF) in the brain. In order to drain extra fluid from the brain's ventricles, a catheter must be inserted.

An EVD drain is primarily used to monitor and regulate the internal pressure of the skull. Head trauma, hemorrhages, and other neurological disorders can all lead to increased intracranial pressure. The EVD drain relieves this pressure, preventing further harm.

What is EVD Drain?

An External Ventricular Drain (EVD) is a transient apparatus that facilitates the evacuation of surplus fluid, including Cerebral Spinal Fluid (CSF), from the spine and brain. This is achieved through the insertion of a slender tube from the cranium into an external collection bag.

EVD Drain Placement

The right lateral ventricle's frontal horn, which is close to the foramen of Monro, is the best area to put an External Ventricular Drain (EVD). When right frontal placement is not feasible because of cerebral pathological indications, a left frontal site may be taken into consideration. The location of Kocher's point, where the EVD is inserted, is about 12 centimeters from the nasion and 1 centimeter anterior to the coronal suture.

EVD Drain Nursing Care

Important nursing considerations for their management include the following:

It is vital to maintain a sterile, closed drainage system and replace the entry site dressing solely when it becomes soiled or becomes loose.
An hourly observation of the EVD site is recommended, and any leaks found should be reported to the neurosurgical team and AUM.
The hourly documentation of drain management should include close monitoring of CSF drainage and hourly documentation of ICP waveform analysis.
CSF loss occurs in patients with an EVD, whereas the body would typically reabsorb it. Under the guidance of a neurosurgeon, CSF losses may be substituted with 0.9% normal saline, mL for mL.
In order to guarantee electrolyte stability, patients with an EVD might need to undergo daily full blood counts as well as urea and electrolyte assessments.

EVD Drain Safety of MRI

External ventricular dilation (EVD) catheters are intended for temporary usage in order to remove fluid from the brain's ventricular cavity in order to relieve high intracranial pressure or fluid accumulation. It is essential to confirm that every element of the EVD set utilized with the ICP probe is "MR Safe" or "MR Conditional" in order to ensure MRI safety.

EVD Drain Setting

In the event that the patient is lateral, the EVD system should be leveled to the mid-sagittal line, and in the case of a supine patient, to the tragus of the ear. The amount of CSF drainage is usually determined by setting the drainage pressure at a certain level, like 5 cmH2O. For instance, in the event that the ICP is below 15 cmH2O and the drain is adjusted to a height of 15 cm, drainage will not occur.

ICD-10 for EVD Drain

The presence of a cerebrospinal fluid drainage device is classified as ICD-10 code Z98.2. When a cerebrospinal fluid drainage device is present, it is indicated by this code.