Which nursing intervention helps decrease intracranial pressure?

• A. Keep head and body midline
• B. Suction only when necessary
• C. HOB at 30 degrees
• D. Provide a calm environment with dimmed lights

Answer: (C)

Positioning to promote venous drainage from the brain is crucial for lowering intracranial pressure. Elevating the head of the bed to about 30 degrees helps facilitate jugular venous outflow, which reduces cerebral blood volume and, in turn, lowers ICP. This angle is a reliable, direct way to improve cerebral drainage and potentially preserve cerebral perfusion if the mean arterial pressure is adequate.

Keeping the head and body in proper alignment supports unobstructed venous return, but the 30-degree elevation provides the most consistent ICP reduction. Suctioning should be minimized because it can transiently raise ICP through coughing and increased intrathoracic pressure. A calm environment with dimmed lights helps reduce metabolic demand, which is beneficial, but the most impactful change for ICP is the head-of-bed elevation.