The effect of Routine nursing care procedures on the ICP in severe head injuries.

The intracranial pressure (ICP) was monitored in a number of patients who were being treated by mechanical ventilation for head injury. The effect on the pressure of routine nursing procedures was studied. Fourteen out of thirty-three cases (group 1) showed small reversible rises in ICP during suction, insertion of a N/G tube, or i.m. injections. These were associated with similar small increases in intrathoracic pressure and small fluctuations in arterial blood pressure. These rises were effectively treated with additional doses of relaxants. In a small group of patients (group 2) irreversible intracranial hypertension was induced by some of these stimuli, but did not respond to the administration of more relaxants, although sedatives such as papaveretum reduced it in some cases, but only slightly.