PLACE LABEL HERE

EVD / ICP MONITORING

(External Ventricular Drain / Intracranial Pressure)

ORDERS

The following orders will be implemented. Orders with a “” are choices are NOT implemented unless checked.

Initial all handwritten order modifications and the bottom of each page when indicatated (multipage).

Select EVD/ICP Device and Treatment Orders

  1.  EVD Orders (Drain Only)

Level EVD to: ____ cm H2O or  ____ mmHg above the external auditory canal.

Drain CSF (Choose One)

 Continuously

OR INTERMITTENTLY

 Open drain every hour and drain ____ mls, then reclamp.

HOB to ≥ 30°

Notify physician if: ______

  1.  Intraventricular Bolt / Flex Catheter(ICP Monitor and Drain)

Level EVD to: ____ cm H2O or  ____ mmHg above the external auditory canal

Drain CSF (Choose One)

 Continuously

OR INTERMITTENTLY

 If ICP > _____ for _____ min, then open EVD drain for ____ min and recheck ICP

 Open drain every hour and drain ____ mls, then reclamp.

HOB to ≥ 30°

Decrease stimulation

Insert Arterial Line by RT

Monitor Arterial BP q 1 hr

Monitor ICP q 1 hr

Monitor CPP q 1 hr (CPP = MAP – ICP)

Maintain ICP < ___ mmHg

Maintain PCO2 35-45mmHg

Control body temperature. May use cooling blanket for body temperature > 102°F.

Notify physician if: ______

  1.  Parechymal Bolt (ICP Monitor Only)

HOB to ≥ 30°

Decrease stimulation

Insert Arterial Line by RT

Monitor Arterial BP q 1 hr

Monitor ICP q 1 hr

Monitor CPP q 1 hr (CPP = MAP – ICP)

Maintain ICP < ___ mmHg

Maintain PCO2 35-45 mmHg

Control body temperature. May use cooling blanket for body temperature > 102°F.

Notify physician if: ______

*3-18633*FORM 3-18633 REV. 12/2015 WHITE: Medical Record CANARY: Pharmacy Page 1 of 2

PLACE LABEL HERE

EVD / ICP MONITORING

(External Ventricular Drain / Intracranial Pressure)

ORDERS

The following orders will be implemented. Orders with a “” are choices are NOT implemented unless checked.

Initial all handwritten order modifications and the bottom of each page when indicatated (multipage).

SCHEDULED MEDICATIONS

  1. Hypertonic/Osmotic Infusion Therapy

Hold for Serum Osmolality greater than ______. Hold for Serum Sodium greater than ______.

Serum Na & Serum Osmolality q __ hrs while on hypertonic/osmotic therapy

 Mannitol 20% 0.5 gm/kg IV q ______hr

 Mannitol 20% 1 gm/kg IV q ______hr

 3% Saline IV ______ml IV bolus q ______hr

 3% Saline IV continuous infusion at ______per ml/hr for __ hours

PRN MEDICATIONS

  1. Hypertonic/OsmoticInfusion Therapy As Needed

Hold for Serum Osmolality greater than ______. Hold for Serum Sodium greater than ______.

Serum Na & Serum Osmolality q __ hrs while on hypertonic/osmotic therapy

 Mannitol 20% 0.5 gm/kg IV q ______hr prn if ICP greater than ___ mmHg sustained for 5 min

 Mannitol 20% 1 gm/kg IV q ______hr prn if ICP greater than ___ mmHg sustained for 5 min

 3% Saline IV ______ml bolus q ______hr prn if ICP greater than ___ mmHg sustained for 5 min

ADDITIONAL ORDERS:

______

______

______

______

______

______

______

Date Time Physician SignaturePID Number

FORM 3-18633 REV. 12/2015 WHITE: Medical Record CANARY: Pharmacy Page 2 of 2