Management of External Ventricular Drains During Intrahospital Transport for Radiographic Imaging

Critically ill patients with brain injury often need intracranial pressure (ICP) monitoring. The two most common methods of ICP monitoring are via an external ventricular drain (EVD) catheter and via an intraparenchymal fiberoptic catheter. In addition to ICP monitoring, an EVD has the additional advantage of being able to treat hydrocephalus or lower elevated ICP by cerebrospinal fluid drainage. In addition to ICP monitoring, frequent radiographic imaging is also considered to be a fundamental component of neurological multimodal monitoring. As such, patients with EVDs often require intrahospital transport for advanced imaging. There are currently no national or international standards guiding intrahospital transport to and from the radiology suite. We use a fictional case to describe practice patterns and variations that may improve care of the patient with EVDs during transport to radiology. The fundamentals for ICP monitoring are highlighted, and an emphasis is placed on clear and concise communication.