A 37-year-old patient involved in a motor vehicle accident sustained a head injury resulting in a subdural hematoma. The nurse caring for the patient noticed that he was confused but later on became unresponsive with a blood pressure of 100/60 mmHg. As the nurse transports the patient to the operating room, which of the following is the most effective position for the patient?

Explanation

• A person with a subdural hematoma can have a dangerously elevated intracranial pressure. As ICP rises, the venous blood pressure may be observed to decline.

• To decrease the intracranial pressure, the patient must be positioned with the head elevated about 30˚ in semi Fowler's. 

• Incorrect: The supine position will not help reduce ICP. 

• Incorrect: Patients who are not fully conscious can have a compromised airway while in the high Fowler's position, and sudden seizures in head-injured patients are a risk in this position. 

• Incorrect: For patients with possible increased ICP, Trendelenburg (head-down) is contraindicated.

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