CCP Podcast 036: Head of Bed Elevation and Reflux

Lynn Schallom is a research scientist at the Barnes-Jewish Hospital in St. Louis. She published a paper 'Head of Bed Elevation and Early Outcomes of Gastric Reflux, Aspiration, and Pressure Ulcers' in the American Journal of Critical Care in January 2015.

Head of Bed Elevation

There is a conflict between the need to keep a patients head elevated to reduce the incidence of oesophageal reflux and consequent pneumonia, and the prevention of pressure ulcers. Can we do both? In her very small study Lynn seems to show that head of bed elevation is important and that we can. She also highlights some other areas of concern, one of which is the use of the trendelenberg position when sliding patients up the bed. This would seem to put patients at increased risk of aspiration as their secretions are encouraged to run in the 'wrong' direction!