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<< Ventriculoperitoneal Shunt Complications In Children: An Evidence-Based Approach To Emergency Department Management

Treatment

Management depends on the type of VP shunt complication that is suspected. Overall, treatment of an infection is different from treatment of a mechanical or functional failure. As always, assess the patient’s vital signs and mental status. If there is concern for severely increased ICP or herniation, a shunt tap is indicated.

Shunt Tap

Most shunts are tapped by neurosurgeons. Indications for an emergency physician to tap a shunt include presentations consistent with severely increased ICP and impending herniation, or acute deteriorations in mental status when neurosurgery is not immediately available. Tapping the shunt in these scenarios could be life-saving. In addition, the procedure can be diagnostic, depending upon the flow of CSF and the results of CSF laboratory studies.1

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