gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Safety deficits of shunt emergency cards and proposal for improvements

Meeting Abstract

  • B. Vienenkötter - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • C. Dictus - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • A. Unterberg - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • M. Schlieter - Radiologische Klinik, Universitätsklinikum Heidelberg
  • A. Aschoff - Neurochirurgische Klinik, Universitätsklinikum Heidelberg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.08-05

DOI: 10.3205/09dgnc166, URN: urn:nbn:de:0183-09dgnc1663

Veröffentlicht: 20. Mai 2009

© 2009 Vienenkötter et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: 273 hydrocephalus valves have been designed, 170 are on the market, 12 of them with sophisticated adjustment procedures and special instructions concerning MRI. The information of patients, parents, doctors – especially neurosurgeons and radiologists – became more and more difficult and is highly at risk for failures. In spite of the high impact on practice only one single paper was published by Frank in 1988. Systematic investigations of shunt cards are completely missing.

Methods: We compiled a list of 35 essential and useful data, which should be included in a shunt emergency card, evaluated 14 cards of 6 manufacturers and developed a new optimal card.

Results: Essentials are name, date of birth, basic disease (causing hydrocephalus), type of hydrocephalus, first operation, revisions, type of shunt (e.g. VP, VA, LP), proximal catheter(s), prechamber + position, valve type + pressure + pumping option, adjustability (+ x-ray-code of ranges, instructions for MRI), position of distal catheter, implanting hospital (+ phone), allergies (latex), coagulopathies, anticoagulation. Useful are x-rays of valve in relation 1:1, phone/e-mail of relatives, family doctor and producer, emergency information for non-professionals. All information should be printed in English and the local language. A suitable design requires each one page for information about the proximal and distal catheter and two pages about the valve. The format must be compatible to a purse (65x100 mm). The evaluation of existing cards showed serious deficits. The poorest card contained 7/35 data only, the best 26/35. The problem of necessary information provided by earlier x-rays, CT-/MRI-Scans, medical letters, op-reports, multilingual handling instructions etc, which was often out of reach in the past, could simply and cheap (4€/1GB) be supplied by a tiny SD-card (2x31x24 mm) within the emergency card, which can communicate via USB or directly with every PC.

Conclusions: Shunt emergency cards should contain 35 essential data about shunt and valve configuration, causes for hydrocephalus and potentially vital diseases (allergies) and connectivity (hospitals, relatives, producers). A supplementation with a common and cheap SD-card could supply medical data such as CT-/MRI-scans and medical reports. We actualized the concept of an emergency card (Aschoff 92, used by Codman-Medos) with more essential data and a SD-card for all necessary medical information incl. CT-Scans and MRIs.