Introduction: monitoring intracranial pressure is crucial in patients with severe head injury. During body hygiene, such patients can have potentially harmful raising of intracranial pressure, which can result in serious secondary damage. This article identifies strategies that should be adopted during body hygiene, in order to keep intracranial pressure within a safe range. Material and methods: narrative review, performed on PubMed, Cochrane Library, CINAHL. The relevancy of the articles was assessed based on their title and the abstract . Results: 13 fundamental aspects of time of hygienic care were identified: start and duration of the procedure, water temperature, hemodynamic monitoring, ensuring an adequate cerebral perfusion pressure, respiratory monitoring, hyperventilation, management of postures, aspiration of bronchial secretions, eye hygiene, oral hygiene, hygiene of the nose, neurosensory stimulation, and pupil assessment. Discussion: performing hygienic care on patients severe traumatic brain injury can raise intracranial pressure, thus causing serious and even potentially lethal damage. The patient receives intense neurosensory stimulation, which can potentially undermine hemodynamic and respiratory stability. This literature review showed that several aspects of patients hygiene, such as sponging, perineal and ears hygiene, are only mentioned in a small number of studies, while others have not studied at all. Hmodynamic and respiratory monitoring instead are treated extensively. Conclusions: nurses should carefully monitor patients before, during, and after hygiene; caution is needed with these delicate patients, even while performing procedures which are only apparently simple, such as body hygiene, in order to prevent sudden increase of intracranial pressure.
Soprattutto durante le cure igieniche, potrebbe essere soggetto a innalzamenti potenzialmente dannosi con rischio di gravi danni secondari. L’articolo identifica strategie da mettere in atto durante le cure igieniche per mantenere la PIC entro soglie di sicurezza. Materiali e metodi: revisione bibliografica su PubMed, Cochrane Library, CINAHL. La pertinenza degli articoli è stata valutata in base al titolo e all’abstract. Risultati: è stata condotta una revisione della letteratura identificando 13 aspetti fondamentali: inizio e durata delle cure igieniche, temperatura dell’acqua, monitoraggio emodinamico, garanzia di un’adeguata pressione di perfusione cerebrale, monitoraggio respiratorio, iperventilazione, gestione delle posture, aspirazione delle secrezioni bronchiali, igiene degli occhi, igiene orale, igiene del naso, stimolazione neurosensoriale, valutazione pupillare. Discussione: le cure igieniche sono un momento assistenziale fondamentale in neurorianimazione. Le manovre infermieristiche possono alzare la PIC, causando gravi danni anche potenzialmente letali. Il paziente infatti subisce una stimolazione neurosensoriale così importante da minarne potenzialmente la sua stabilità emodinamica e respiratoria. Dalla revisione bibliografica è emerso che alcuni aspetti peculiari, come le spugnature, l’igiene perineale e delle orecchie, sono citati unicamente in un esiguo numero di studi o addirittura per nulla presenti. La parte riguardante il monitoraggio emodinamico e respiratorio invece è trattata ampiamente. Conclusioni: l’infermiere dovrebbe seguire le evidenze di letteratura nell’eseguire le cure igieniche in sicurezza e cercare di limitare il più possibile la stimolazione neurosensoriale per mantenere la PIC entro soglie di sicurezza.
L’impatto delle cure igieniche sulla pressione intracranica del paziente con trauma cranico severo : revisione della letteratura = The impact of hygienic care on intracranial pressure in patients with severe head injury: a review of the literature / V. Capellini, S. Terzoni, A. Destrebecq, A. Longobardi. - In: SCENARIO. - ISSN 1592-5951. - 2015:2(2015 Jul 07), pp. 31-35.
L’impatto delle cure igieniche sulla pressione intracranica del paziente con trauma cranico severo : revisione della letteratura = The impact of hygienic care on intracranial pressure in patients with severe head injury: a review of the literature
S. TerzoniSecondo
;A. DestrebecqPenultimo
;
2015
Abstract
Introduction: monitoring intracranial pressure is crucial in patients with severe head injury. During body hygiene, such patients can have potentially harmful raising of intracranial pressure, which can result in serious secondary damage. This article identifies strategies that should be adopted during body hygiene, in order to keep intracranial pressure within a safe range. Material and methods: narrative review, performed on PubMed, Cochrane Library, CINAHL. The relevancy of the articles was assessed based on their title and the abstract . Results: 13 fundamental aspects of time of hygienic care were identified: start and duration of the procedure, water temperature, hemodynamic monitoring, ensuring an adequate cerebral perfusion pressure, respiratory monitoring, hyperventilation, management of postures, aspiration of bronchial secretions, eye hygiene, oral hygiene, hygiene of the nose, neurosensory stimulation, and pupil assessment. Discussion: performing hygienic care on patients severe traumatic brain injury can raise intracranial pressure, thus causing serious and even potentially lethal damage. The patient receives intense neurosensory stimulation, which can potentially undermine hemodynamic and respiratory stability. This literature review showed that several aspects of patients hygiene, such as sponging, perineal and ears hygiene, are only mentioned in a small number of studies, while others have not studied at all. Hmodynamic and respiratory monitoring instead are treated extensively. Conclusions: nurses should carefully monitor patients before, during, and after hygiene; caution is needed with these delicate patients, even while performing procedures which are only apparently simple, such as body hygiene, in order to prevent sudden increase of intracranial pressure.File | Dimensione | Formato | |
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