شاب عمره ٢٧ سنة في العناية بعد إصابة رأس شديدة، منبب، وضغط الجمجمة مرتفع بين ٢٢ و٢٥ ملم زئبق. الممرضة المسؤولة تراقب ممرضة جديدة تعتني به. أي تصرف من الممرضة الجديدة يحتاج تدخل؟

A 27-year-old in ICU after severe head injury is intubated with ICP between 22 and 25 mmHg. The charge nurse observes a new nurse caring for him. Which action by the new nurse requires intervention?

1. Head kept in the midline, not turned
2. Avoiding sharp flexion of the hips
3. Head of the bed raised to 30 degrees
4. Suctioning for 30 seconds in several passes

Answer: D) Suctioning for 30 seconds in several passes. Suctioning raises ICP, so keep it brief (under 10 seconds), pre-oxygenate and limit passes.