EVD Placement and Dressing
EVD Placement and Dressing Protocol:
EVD Placement and Dressing Protocol:
- Clean hands with soap/water or alcohol solution
- Broad clipping of hair:
- the entire top of the head
- use both coarse and fine clippers
- Degrease skin using gauze pad saturated with isopropyl alcohol
- Give single dose of antibiotic (e.g. cefazolin) given prior to incision
- No prophylactic antibiotics given after single pre-incision dose
- Chlorhexidine skin prep prior to draping (not iodide prep!)
- Full sterile draping of patient’s head and entire body
- Wear cap, mask, sterile gown, and sterile gloves
- All staff in room wear cap and mask
- Repeat chlorhexidine skin prep after draping
- Use rifampin / minocycline impregnated ventricular catheter (e.g. VentriClear)
- Tunnel catheter 3-5 cm from insertion site
- Dressing:
- Catheter secured in question-mark pattern using surgical staples
- Benzoin tincture applied to skin and allowed to fully dry by evaporation
- Chlorhexidine-eluting patch (e.g. BioPatch) applied over catheter exit site
- do not wrap around catheter
- Medium-sized adherent transparent dressing film (e.g. Tegaderm)
- Secure borders of dressing film with sterile adhesive strips (e.g. SteriStrips)
- No routine dressing changes – change for dressing compromise only:
- If dressing change needed:
- re-clip if needed;
- use full sterile technique including gown, gloves, mask, hat, and draping as above;
- re-prep with chlorhexidine
- If dressing change needed:
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