Q Our physicians are asking the nurses to irrigate ventriculostomy catheters. What is the physiologic effect of irrigating these catheters? What types of solutions and volumes are appropriate? Is this really within the scope of practice for the bedside clinician or should it only be the responsibility of the advanced practice nurses?

A Mary Jo Kocan, rn, msn, cnrn, ccrn, replies:

Ventriculostomy catheters are frequently used to monitor intracranial pressure (ICP) in patients with head injury, ruptured aneurysm, or hydrocephalus. Because the catheter is placed in one of the cerebral ventricles, cerebrospinal fluid (CSF) can also be drained as a method to control ICP. Debris such as tissue fragments or blood clots can obstruct the catheter and compromise the ability to accurately monitor ICP or to reliably drain CSF. Irrigation is a method used to...

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