What are contraindications to HOB elevation to 30º or greater?

Contraindications should be determined by the medical staff of the hospital and documented in some manner (e.g., standards or in the patient’s chart). Following is a non-inclusive list of possible contraindications:

  • Hypotension MAP <70
  • Tachycardia >150
  • CI <2.0
  • Central line procedure
  • Posterior circulation strokes
  • Cervical spine instability – use reverse Trendelenburg
  • Some femoral lines, i.e., IABP no higher than 30º – use reverse Trendelenburg
  • Increased ICP, no higher than 30º and avoid hip flexion
  • Proning

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