Biomaterial Database

Intracranial pressure monitor placement by midlevel practitioners. 1998

K L Kaups, and S N Parks, and C L Morris

University Medical Center, University of California, San Francisco/Fresno Campus, 93702, USA.

BACKGROUND The timely treatment of patients with head injuries is affected by the availability and commitment of neurosurgeons. Use of midlevel practitioners (MLPs) may permit more efficient neurosurgical coverage. Intracranial pressure monitoring is among the most frequently used neurosurgical procedures. The purpose of this study was to examine the placement of intracranial pressure (ICP) monitors by MLPs. METHODS Medical records and trauma registry data for a Level I trauma center were reviewed from December 1993 to June 1997. Patients who had ICP monitors placed were included. Patient data recorded were age, mechanism of injury, injury type, ICP monitor placement and length of placement, complications related to the ICP monitor, and outcomes. RESULTS Two hundred ten patients had 215 monitors placed. ICP monitors were placed by neurosurgeons (105), MLPs (97), and general surgery residents (13), and remained in place a mean of 4 days. No major complications attributable to ICP monitor placement occurred; 19 minor complications (malfunction, dislodgment) were noted. Eleven monitors placed by neurosurgeons (10%), seven placed by MLPs (7%), and one placed by a resident (8%) had complications. CONCLUSIONS ICP monitor placement by MLPs is safe. Use of MLPs may aid neurosurgeons in providing prompt monitoring of patients with head injuries.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007427	Intracranial Pressure	Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity.	Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D008505	Medical Staff, Hospital	Professional medical personnel approved to provide care to patients in a hospital.	Attending Physicians, Hospital,Hospital Medical Staff,Physicians, Junior,Registrars, Hospital,Attending Physician, Hospital,Hospital Attending Physician,Hospital Attending Physicians,Hospital Medical Staffs,Medical Staffs, Hospital,Hospital Registrar,Hospital Registrars,Junior Physician,Junior Physicians,Physician, Junior,Registrar, Hospital,Staff, Hospital Medical,Staffs, Hospital Medical
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D008991	Monitoring, Physiologic	The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.	Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D009493	Neurosurgery	A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system.	Neurosurgeries
D009722	Nurse Practitioners	Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.	Nurse Practitioner,Practitioner, Nurse,Practitioners, Nurse
D010823	Physician Assistants	Health professionals who practice medicine as members of a team with their supervising physicians. They deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. Duties may include physical exams, diagnosis and treatment of disease, interpretation of tests, assist in surgery, and prescribe medications. (from http://www.aapa.orglabout-pas accessed 2114/2011)	Doctor's Assistant,Feldsher,Feldshers,Physician Assistant,Physicians' Assistants,Physicians' Extender,Physicians' Extenders,Doctor's Assistants,Assistant, Doctor's,Assistant, Physicians',Assistants, Doctor's,Assistants, Physician,Assistants, Physicians',Doctor Assistant,Doctor Assistants,Doctors Assistant,Extender, Physicians',Extenders, Physicians',Physician Extender,Physician Extenders,Physician's Assistants,Physician's Extender,Physician's Extenders,Physicians Assistants,Physicians Extender,Physicians' Assistant
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children