Telemetry Bandage Guide EEGLTM And Invasive Monitoring Invasive

Telemetry Bandage Guide EEG-LTM And Invasive Monitoring

Invasive Bandage Guide Kelly St. Pier October 2011

Protecting the patient and the recording • The bandage is a first line protective cover for the patient and the recording • This guide should help protect the wound and the recording but your nursing guidelines should cover looking after invasive patients more extensively • Think of the electrodes as being similar to a drain – do not be scared of them - just try and protect them

Remember…. the cables can act as a vehicle for infection and so a sterile environment is essential. Nurses are well practiced but families like to help and should be discouraged from helping…. . Their cleanliness is just as important as the staff so if they help – their cleanliness is just as important as yours! LET’S START WITH WHAT TO AVOID…. . If the cables are dangling down the back of the patients head and unsupported then gravity will take it’s effect……… Even if the bandage is under the chin, over time the bandage will go south and come off. The patient will also be uncomfortable if they are lying on them and the cables will not be being adequately protected………. .

ELECTRODE CABLES When the patient comes back from surgery, ideally they should have a tight bandage applied in surgery with the cables coming out of the top of the head, taped loosely to the bandage and visible for the physiologist to attach to the recording cables. Again ‘Ideally’ this bandage should stay on for most if not all of the admission unless the wound needs checking due to oozing etc……but in reality this is unlikely due to our patient population and the duration of the recording (~up to 7 days on average)

ELECTRODE CONNECTIONS – CONNECTING/DISCONNECTING You should hopefully not have to concern yourself with this. However just for your information……but if you are required to help or a connection comes disconnected…. Some cables have in-built/non disposable plastic connections where you slide the cable into the connector that then clips firmly into place. Make sure it clips into place by gently squeezing the connector shut otherwise the cable could slide out.

ELECTRODE CONNECTIONS – CONNECTING/DISCONNECTING Some cables have disposable plastic connections where you slide the cable into the connector that then attaches to the cable. Be careful when connecting this particular cable/connector as the gold pins are quite soft and bend.

GOOD EXAMPLE OF A BANDAGE How do we achieve this look?

ELECTRODE CABLE POSITIONING Some patients have several connectors which occupies lots of space. It is best if each cable is positioned and taped separately at the front of the head in a semi-circle (tape the cable and not the wire coming out of the head/brain). If they are all clumped together this will make it uncomfortable for the patient, unsightly and with the pull of gravity make it more likely to make the bandage slide off the head.

Starting the bandage 2 -3 people are required for stead and ease. Always start from one ear and go straight under the chin (never just around the head like a hat as this will always fail! The bandage can be relatively lose under the chin but due to the weight of the electrode cables the bandage MUST be under the chin at the outset. Wrap then around the head to cover all the cable/head with plenty of elastoplast. Cut short and long pieces – be generous. The tape will help to hold the bandage in place and so using only short pieces will not be adequate. 2 bandages will be required to adequately cover and protect the cables. The neurosurgical nurses also have a great elastic band like device that can then be stretched from the top of the head under the chin to further protect the patient and the recording if the patient will tolerate it.

THE ‘PRINCESS NERFETITI’ LOOK TO ACHIEVE Anyone who has never looked after an invasive patient should practice on our head model or another colleague……!!!