For stroke patients, hospital bed position is delicate balancing act

Posted: Published on October 30th, 2014

This post was added by Dr Simmons

PUBLIC RELEASE DATE:

30-Oct-2014

Contact: Jim Ritter jritter@lumc.edu 708-216-2445 Loyola University Health System @LoyolaHealth

MAYWOOD, Ill. (Date) During the first 24 hours after a stroke, attention to detail --such as hospital bed positioning -- is critical to patient outcomes.

Most strokes are caused by blood clots that block blood flow to the brain. Sitting upright can harm the patient because it decreases blood flow and oxygen to the brain just when the brain needs more blood.

Thus, it's reasonable to keep patients lying flat or as nearly flat as possible, according to a report in the journal MedLink Neurology by Loyola University Medical Center neurologist Murray Flaster, MD, PhD and colleagues.

But strokes also can increase intracranial pressure (brain swelling) that can damage the brain. Sitting upright helps improve blood drainage and reduce intracranial pressure -- but at a cost of reduced blood flow to the brain.

"There are few data to guide decision making in this difficult situation," Flaster and colleagues write.

Further complicating stroke care, some patients have orthopnea (difficulty breathing while lying flat). In such patients, the head of the bed should be kept at the lowest elevation the patient can tolerate.

Finally, frequent changes in body position, regardless of head position, may help patients tolerate lying flat, while also minimizing the risk of bed sores, the Loyola neurologists write.

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For stroke patients, hospital bed position is delicate balancing act

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