MANAGEMENT OF ICP IN CRITICALLY PATIENTS WITH SEVERE TBI, NURSE INTERVENTIONS: SCOPING REVIEW

Abstract

The Gold Standard in the treatment of the patient with severe Traumatic Brain Injury is the prevention of secondary injury. The nurse’s actions, through surveillance and early identification of outbreaks of instability and the implementation of interventions aimed at patient safety, contributes to its prevention/reduction. Objective: To map the scientific evidence on nursing interventions for the management of ICP in patients with severe TBI in intensive care units.  Methodology: Recourse to a scoping review using the Joanna Briggs Institute Methodology. The search was carried out in the CINAHL Complete, MEDLINE Complete, Psychology and Behavioral Sciences Collection and MEDIC LATINA databases. Articles that included nursing interventions for ICP management published between 2011 and 2021 were selected. Results: The nursing interventions that seem to have a positive effect on the reduction of identified ICP were elevation of the patient´s head, positioning, limitation of external stimulation, auditory stimulation with familiar voices, endotracheal suction, oral care, temperature control, management of pain and agitation control, and cerebrospinal fluid drainage. Conclusion: Most studies do not support a direct, clear and significant association between implemented strategies and ICP management.