World J Surg Surg Res | Volume 3, Issue 1 | Short Communication | Open Access

Minimizing Door to Treatment Time: Creating a “Go Bag” for External Ventricular Drain Placement

Redi Rahmani*, Clifton Houk, Catherine Gargan, Audrey Paulzak, Jamie Fodness and Debra Roberts

Department of Neurological Surgery, University of Rochester School of Medicine and Dentistry, USA

*Correspondance to: Redi Rahmani 

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Introduction: An External Ventricular Drain (EVD) is used to divert Cerebrospinal Fluid (CSF)
away from the ventricles when there is obstruction of normal flow. The most urgent indication for
an EVD is acute obstructive hydrocephalus causing brain herniation. The Neuro-Medicine Intensive
Care Units (NMICU) multi-disciplinary Unit based Perform Program (UPP) team hypothesized an
EVD “Go Bag” containing all the equipment needed for EVD placement would reduce the time
between the decision to place an EVD and the procedure start time.
Materials and Methods: The NMICU UPP team designed a bag with all equipment needed for
EVD placement. A system was developed where the bag was checked and restocked daily. Two
neurosurgery residents performed time trials, measuring the time from the decision to place an
EVD, to collecting the equipment from the NMICU and returning to the patient’s bedside in the
emergency department. Times were compared with and without using an EVD “Go Bag”.
Results: Implementation of the EVD “Go Bag” reduced mean time to begin EVD placement from
17 min to 4 min (p<10 to 6).
Conclusion: The EVD “Go Bag” significantly decreases the time to placement of an EVD when
compared to residents gathering EVD equipment. It should also both decrease nursing time
required for material procurement and improve tracking of materials used.




Rahmani R, Houk C, Gargan C, Paulzak A, Fodness J, Roberts D. Minimizing Door to Treatment Time: Creating a “Go Bag” for External Ventricular Drain Placement. World J Surg Surgical Res. 2020; 3: 1200..

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