Abstract

EFFECT OF SUPINE VERSUS SEMI-FOWLER'S POSITIONS ON HEMODYNAMIC STABILITY OF PATIENTS WITH HEAD INJURY

Manzoor A Mir, Amal A AlOtaibi, Raid S Albaradie and Jehan Y ElRazkey*

Abstract

Objective: Traumatic brain injury is challenging practice for neurosurgical nurses. Intracranial hypertension is generally recognized to be the primary cause of death in patients with head injury and intracranial hemorrhage. Patient positioning has a profound effect on hemodynamic stability of head injured patients. The current study aimed to determine the effect of supine versus semi-fowler's positions on hemodynamic stability of patients with head injury. Methods: Fifty adult patients, diagnosed as head injury were included on in a quasi-experimental randomized clinical trial, over a period of 8 months, and were equally assigned into two groups. Group I was positioned on semi-fowler's position 30 for two hours. Group II was positioned on supine position for two hours. Quantitative hemodynamic "temperature, pulse, respiration, blood pressure, pulse pressure, and level of consciousness using Glasgow coma scale (GCS)" were monitored before and after positioning patients for both groups. Results: proved that group I had experienced improvement of hemodynamic parameters, as systolic blood pressure returned to normal range, pulse pressure decreased to normal compared to widening state before positioning, patient's level of consciousness had improved as measured by GCS, and diastolic blood pressure maintained within normal. no changes in temperature, pulse, and respiration for both groups. Conclusion: semi-fowler's position was more effective than supine position in hemodynamic stability of patients with head injury.

Keywords: Traumatic brain injury, Fowler’s position, Glasgow comma scale, Supine position, Blood pressure, intracranial pressure and cerebral perfusion pressure.