Shunt tips

[thesophist]

Does anyone have any personal tips on shunts and freehand EVDs? I'd really appreciate some general do's an dont's, as well as any specific troubleshooting points.

[Focus]

(02-16-2017, 10:09 AM)thesophist Wrote: Does anyone have any personal tips on shunts and freehand EVDs? I'd really appreciate some general do's an dont's, as well as any specific troubleshooting points.

Find a way you like to do it and unless your messing up in a reproducable manner be very resistant to changing based on othetbpeoples pov. Deviating from what works best for you can land you into serious mistakes.

Always mark out the trajectories. For EVDs I make my incision along the anterior posterior trajectory because its will never be smudged that way. 

If you felt like you were in dont be quick to re attempt the pass. Drop the head of the bed and attach a syringe with no plunger to the catheter drop 5cc of sterile preservative free saline in it and see if you can get it to flow into the ventricles. 

Trying to thread a shunt catheter through the tunneling cannula is a pain. You can tie a long silk to the tip of the shunt tunneler and then use that to pull the shunt tubing through after you remove it.

Never go deeper than 7 no matter the tight spot you are in.

The most common reason a shunt doesnt work after you connect it is air bubbles in the tubing.

[Guest]

(02-16-2017, 10:09 AM)thesophist Wrote: Does anyone have any personal tips on shunts and freehand EVDs? I'd really appreciate some general do's an dont's, as well as any specific troubleshooting points.

I was browsing the wiki and whoever wrote this up did an ok job: http://neurosurgeryhub.org/wiki/tiki-ind...tomy+-+EVD