Moving the patient in bed: effects on intracranial pressure

Intracranial pressure (ICP) was measured in 20 patients before and after each of eight nursing care activities: turning the body to four positions, passive range of motion (arm extension and hip flexion), and rotation of the head to the right and to the left. Technically usable data was available for 18 patients. Mean ICP increased for at least five minutes in all patients after one of the four turns and in 88 percent after half the turns. Change in mean ICP with one of a pair of lateral or supine turns was strongly predictive of the direction of change (increase or decrease) of the other turn of the pair. Large increases in ICP occurred in the five patients for whom head rotation was done, while there was minimal change in ICP with both passive range of motion procedures. A cumulative increase in ICP occurred with activities spaced 15 minutes apart, regardless of the nature of the activity. No cumulative increase in ICP was found with procedures spaced at least one hour apart.