over a 3-year period, the sample is relatively small,
which reflects the low prevalence of TBI in children in
the UK (Parslow et al., 2005).
CONCLUSIONS
Two of the five most commonly performed nursing
interventions have been shown to produce significant
intracranial hypertension in children with moderate
to severe TBI in intensive care. Both endotracheal
suctioning and LR caused mostly transient intracranial
hypertension, whereas eye care and oral care produced
little change in ICP even in the children with severe
injury. Washing showed some evidence of elevating
ICP but needs further investigation. After decompressive
craniectomy, none of the above interventions
caused significant intracranial hypertension.
ACKNOWLEDGEMENTS
We are especially grateful to the nursing staff of the
PICU for their assistance with data collection in this
project, and to the PIC consultants and consultant
paediatric neurosurgeons for their support with this
project.