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학습 자료 둘러보기 →For a patient with severe TBI and an ICP of 25 mmHg, the first action is to elevate the head of bed to 30 degrees and ensure neutral head alignment. This uses gravity to promote cerebral venous outflow, directly reducing intracranial blood volume.
Maintaining a neutral neck position is critical; any flexion, extension, or rotation can compress the jugular veins, obstructing venous return and paradoxically increasing ICP. This intervention is low-risk, requires no order, and can be done immediately.
Avoid routine hyperventilation to a PaCO2 of 25-30 mmHg. This causes cerebral vasoconstriction and can lead to ischemia. It is reserved only for acute herniation syndromes. Always follow a least-to-most invasive approach.
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