ABSTRACT
The insertion of an external ventricular drain (EVD) is one of the most important life-saving procedures undertaken in the neurointensive care unit. It is the standard of care for temporarily controlling intracranial pressure (ICP) by draining the cerebrospinal fluid (CSF) in emergency neurosurgical scenarios with severe intracranial hypertension, such as hydrocephalus, hemorrhage, tumor, meningitis, or brain trauma. It is the gold standard technique to monitor the intracranial pressure in severely brain-injured patients, thereby serving as a guide for targeted resuscitation. At the same time, ventriculostomy drains also aid in the drainage of intraventricular blood and instillation of intraventricular medications when indicated. EVD catheters are a relatively safe and reliable method of intracranial pressure monitoring and ventricular decompression. Institutional EVD management bundles can help to improve the care and outcome of patients by keeping ventriculostomy-related infection rates to a minimum. Current guidelines strongly support thromboembolism prophylaxis and antibiotic impregnated catheters in these patients. Finally, good and accountable nursing care is the harbinger of better outcomes in patients with EVDs.
