keeping HOB flat with neuro patients

[wanderlust99]

Do you guys ever keep your pt's HOB flat when air or fluid is shown on the CT? In the past I worked somewhere where if air was shown on the head CT, we'd keep them flat and put them on 100% NRB for awhile. New place I'm working I've noticed the neurosurgeon ordering to keep HOB flat or keep flat and don't turn on a particular side in hopes it will help with excess fluid in brain. (never patients w/evds in...30 degrees of course). Anyone do anything like this, or know what I'm referring to? Thanks! I just can't find the rationale for this online. Ugh...neuro was never my strong point:rolleyes:

[Nccity2002, MSN, RN]

Found these couple articles online, hope it helps.:)

1) http://thejns.org/doi/abs/10.3171/JNS/2008/108/5/0926?cookieSet=1&journalCode=jns

2)https://allnurses.com/neuro-intensive-care/pneumocephalus-306128.html

[MeTheRN, BSN, MSN, RN]

If the patient has pneumocephaly, we definitely keep them flat and give 100% O2. But doing it for fluid purposes doesn't make any sense. In theory, with excess fluid in the brain, drainage would be facilitated by elevating the HOB. Are you sure the patient didn't have a little air as well as fluid on the CT?