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Epilepsy surgery: invasive monitoring for epilepsy surgery, nursing management

This guideline is intended to guide and facilitate the care of patients under the care of the clinical teams at Great Ormond Street Hospital for Children NHS Trust (GOSH). It has been approved by the Guideline Approval Group and is for use by staff of all disciplines and levels in these health care teams. The guidance contained here in is not intended to replace individual assessment and personalised treatment of the patient.

Mouth care

The purpose of this guideline is to provide guidance about mouth care at Great Ormond Street Hospital (GOSH).

NOTE: We review our guidelines regularly and this guideline is now past its review date. The content of the guideline below may not reflect the most recent evidence based practice. Please use with caution.

Skin biopsy: punch method

The skin is complex with an array of functions. It is the body’s largest organ, protecting the deeper tissues and organs from mechanical damage, chemical damage, bacterial damage, ultraviolet radiation and thermal damage. The skin aids in regulating body temperature, in excretion of urea and uric acid and also synthesis of vitamin D (Marieb 2012). 

Administration of Non-Cytotoxic Medication via an Intracerebroventricular Reservoir

The purpose of this document is to provide guidance for the administration of non-cytotoxic injection or infusion via an Intracerebroventricular (ICV) reservoir at Great Ormond Street Hospital (GOSH). 

This guideline is to be used for the administration of cerliponase alfa/BMN190 and may need to be adapted for administration of other ICV medications. 

For intrathecal or ICV administration of cytotoxic drugs please see the clinical guideline; Intrathecal cytotoxic chemotherapy: administration via a lumbar puncture or Ommaya reservoir.

Gastrostomy management

A gastrostomy is a feeding tube that is inserted directly into the stomach either surgically under direct vision (open or laproscopic), endoscopically (with a camera), or radiologically (x-ray guidance). A gastrostomy tube allows the delivery of supplemental nutrition and medications directly into the stomach. It also provides a mechanism to drain gastric contents if required. In order for gastrostomy feeding to be successful the child or young person must have a functioning gastrointestinal tract.