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The best position for ICP waveform monitoring is a resting supine position at 30 degrees with the chin and sternum aligned (Figure 6.7-1) and the head should not be tilted. The patient must be resting and avoid any movements since that can interfere with the ICP waveform reading.
Figure 6.7-1 - Resting supine position at 30 degrees.
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PRECAUTION - The position, or movement, of the patient and the BcSs-PICNIW-1000 Sensor is known to affect the signal being recorded. As a result, if multiple recording sessions are obtained on the same patient, consistent positioning of the patient and device will lead to more comparable recordings. |
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WARNING - The appearance of a normal waveform morphology does not eliminate the possibility of elevated intracranial pressure or irregularity in brain compliance. |
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ATTENTION - The waveforms above are examples of typical noninvasive ICP waveforms in different clinical settings. You may see variations in the ICP waveform, but they should always follow a similar pattern. |
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WARNING - The appearance of a normal waveform morphology does the eliminate the possibility of elevated intracranial pressure or irregularity in brain compliance. |
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WARNING - The clinician is reminded to assess the waveform morphology in real-time during a monitoring session. The B4C report is available for the clinician’s convenience to review associated waveform parameter estimates and other clinical observations entered in a past monitoring session |
6.7.2 verifying the ni-ICP signal quality in patient monitors using the receiver
After correctly placing the sensor on the patient’s head and pairing with the receiver the waveform should accurately appear on the monitor. Good positioning of the headband and proper placement of the sensor will result in typical waveforms as depicted below (Figure 6.7-5). Note: the figure below is simply an illustration of a sample waveform.
Figure 6.7-5 - Good waveform reading
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ATTENTION - The waveforms acquired from non-invasive ICP method do NOT represent actual mmHg values on the patient monitor scale. |
If the signals shown on the monitor do not present any of the characteristics seen in the depiction above (the signal should at least present identifi able identifiable P1 and P2 peaks), modify the position of the sensor on the patient’s head by shifting and/or tightening/ loosening the headband until a satisfactory pulse waveform is obtained. An example of a poor reading is depicted below (Figure 6.7-6).
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ATTENTION - Trained Personnel are expected to recognize proper waveform quality. |
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Figure 6.7-6 - Waveform requires adjustment