[luv2shopp85]

I have a questoin about head injuries and head surgeries. I know that most of the time with procedures like craniotomy, or if patient has Increased ICP you will keep the HOB elevated. But is there ever a time when you keep the HOB flat? I could have sworn that I learned this sometime during school but I can't figure out what it was for! I tend to always pick this question on my answers but its always wrong. Can someone help me figure out when you want to keep the HOB flat??

[Daytonite]

Hey, kiddo. . .I saw your question about this the other day and started to do a little looking into it and wasn't finding anything. I used to work on a neuro floor and we had all kinds of head injuries. They were all kept with their HOBs elevated and on fluid restrictions. I was trying to remember if there ever were situations were we kept the beds flat. The only thing I kept thinking of were spinal injuries or spinal surgeries, but that's not a head injury. Why don't you try asking this on the SICU forum and see what kind of response you get? I'd also want to know why they don't need to be elevated since the purpose of elevation is to keep the swelling down. If worse comes to worse on the NCLEX I'd go with elevating the head on a question like this unless you're absolutely sure otherwise.

We're having a heat wave out here! But the sun is shining!

[Melanie_RN]

I worked with neuro for a year, and the only time they're flat is when their spines haven't been cleared. Otherwise its at least 30, you dont want to increase pressure on the brain!

[Beary-nice]

Are you thinking about an infratentorial craniotomy? The bed should be kept flat for the first 24-48 hours and the patient positioned side to side to prevent pressure on the incisional sites. That is the only thing I can remember about HOB being flat.

[luv2shopp85]

Originally Posted by Beary-nice

Are you thinking about an infratentorial craniotomy? The bed should be kept flat for the first 24-48 hours and the patient positioned side to side to prevent pressure on the incisional sites. That is the only thing I can remember about HOB being flat.

Yep thats it!! What is the reason for keeping the HOB flat? Is it so the CSF doesn't leak out of the incision site?

[Beary-nice]

Originally Posted by luv2shopp85

Yep thats it!! What is the reason for keeping the HOB flat? Is it so the CSF doesn't leak out of the incision site?

From what I can remember, it is to keep pressure off the incision that is made in the neck and to keep pressure off the site where the tumor was removed.