How do you position a pt who has ICP and is hypotensive?

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Another stupid question of mine for which I cant find a logical answer,so just let me give you a fictional example,lets say a pt was in a car crash,pupils fixed,dilated to light,obviously much decreased LOC,tachycardic,with a very low blood pressure and pale,cold extremities,from your experience what would be the best position for them? Thanks for your time!!!

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Specializes in Cardiac Telemetry, ED.

I'd have them on their back on a firm surface because it looks like they'll be needing CPR soon.

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Specializes in ED, ICU, Heme/Onc.
I'd have them on their back on a firm surface because it looks like they'll be needing CPR soon.

Unstable patients are in this position or quickly put there. I'd also have the defib pads attached. This is not the time to worry about whether or not the HOB is at a 30 degree angle.

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Supine with head midline

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Specializes in Flight, ER, Transport, ICU/Critical Care.

ICP and hypotension is a BAD combo!

Any systolic drop under 90 dramatically increases the chance of death. CPP is BP dependent.

HOB elevation will be of little concern. The soon-to-follow bradycardia and drop in respiratory rate is what you will really need to be alert for - really alert.

Bad juju!

Short Answer: Supine, firm surface and have the crash cart at the bedside. And page the neuro and trauma services and rapid response team - STAT!!

Good Luck.

;)

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Thanks for the replies...

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