Effect of Body Position on Oxygenation and Hemodynamic Status among Patients with Traumatic Brain Injury

Abstract

Background: Positioning is one of the most frequently performed nursing activities in the critical care, often providing a central pivotal focus for planning other nursing activities. Therapeutic positioning of the head different degrees of head of bed elevation has been proposed as a low cost and simple way of preventing secondary brain injury. Aim: determine the effect of body position on oxygenation and hemodynamic status among patients with traumatic brain injury. Research design: Quasi-experiments (single group pre/posttest design). Setting: Critical Care Units in El-Mansoura general hospital at El-Mansoura city. Subject: A purposive sample of (67) adult patients diagnosed with traumatic brain injuries. Tools: Structured socio-demographic interview questionnaire, Patients’ medical records (Part (1): covers clinical variables, Part (2): covers cardiorespiratory assessment record), Glasgow Coma Scale and Richmond Agitation Sedation Scale. Result: there was significantly increasing in oxygen saturation in post semi fowler position from (95.37 ± 1.17 to 97.31 ± 11.13) and then right lateral position from (94.93 ± 1.25 to 95.37 ± 1.17) compared to pre. Also, regard hemodynamic parameters (Heart Rate, Respiratory Rate, Systolic Blood Pressure, Diastolic Blood Pressure and Mean Arterial Pressure) were significantly decreased in post semi fowler position and then right lateral position compared to pre. Conclusion oxygen saturation and all hemodynamic parameters were significantly improved regarding normal range in post semi fowler position and then right lateral position compared to pre. Recommendations: Develop nursing practice protocol for critical care nurses to position patients at semi fowler position after traumatic brain injury to improve oxygenation and hemodynamic parameters. And further studies should be carried out in order to assess the effect of other body positions on the other medical conditions.