• A Williams and S M Coyne.
• College of Nursing, Arizona State University, Tempe 85287-2602.
• Am. J. Crit. Care. 1993 Jan 1; 2 (1): 68-71.

ObjectiveTo investigate the effects of four nonneutral neck positions on intracranial pressure.DesignAn alternating treatment design was used to investigate the effect on intracranial pressure of rotation of the head to the left and right, neck flexion and neck extension. Each experimental position was separated by a neutral recovery period.SettingNeurological intensive care units in two tertiary care centers in the southwestern United States.SubjectsTen patients whose intracranial pressure was being therapeutically monitored but who were not experiencing prolonged periods of elevated intracranial pressure.ProcedureEach neck position was maintained manually by the research staff for 5 minutes. Intracranial pressure was recorded at 1-minute intervals throughout the 45-minute data collection period.ResultsRotating the head to the right and left and placing the neck in flexion resulted in significantly higher intracranial pressure readings than the baseline neutral neck position or positioning the neck in extension. The highest individual intracranial pressures always occurred with the head and neck rotated or in flexion.ConclusionsThese data support previous studies that indicated that a patient at risk for pathological increase in intracranial pressure should not be positioned with the neck in flexion or the head turned to either side.

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