Which precaution is recommended after head injury to help prevent increased intracranial pressure?

• A. No coughing, blowing nose, or sneezing
• B. Encourage coughing to clear secretions
• C. Elevate legs above heart level
• D. Keep patient in Trendelenburg position

Answer: (A)

After a head injury, the goal is to keep intracranial pressure from rising. Coughing, sneezing, and blowing the nose are Valsalva-like actions that raise intrathoracic pressure, impede venous drainage from the brain, and can cause a spike in intracranial pressure. Avoiding these acts helps maintain stable ICP and reduces the risk of secondary brain injury.

Encouraging coughing would have the opposite effect by increasing pressure; elevating legs above the heart level would boost venous return and could raise ICP; placing the patient in Trendelenburg position pushes the head lower than the body and directly increases intracranial pressure.