Raised ICP – initial measures — RACP Paediatrics MCQ

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EasyNeurologyRaised ICP – initial measuresRACP Paediatrics

A child with traumatic brain injury has signs of raised ICP. After securing the airway and ensuring adequate circulation, what is the most appropriate initial non-pharmacological measure?

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Correct answer: D — Elevate head of bed to 30°

Elevating the head of the bed to 30° with the head in a midline position is a fundamental first-line measure to reduce ICP. It promotes venous drainage from the brain. The head should be kept midline (avoiding neck flexion or rotation which may compress jugular veins). Other measures include maintaining normothermia and avoiding hyponatraemia.

Reference: RCH Melbourne – 2023 – Raised ICP CPG; RACP Paediatric Curriculum – Emergency