AEMCA Practice Exam

In the case of a patient with cerebral herniation on a spinal board, what position should be taken?

1. Flat on the board

2. Elevate 30 degrees

3. Elevate 15 degrees

4. Lying on the side

The correct answer is: Elevate 30 degrees

In the case of a patient experiencing cerebral herniation, it is crucial to manage the patient's positioning to minimize intracranial pressure and allow for optimal cerebral perfusion. Elevating the head of the stretcher by 30 degrees is considered an appropriate approach because this position can help improve venous drainage from the head and reduce pressure within the cranial cavity. The 30-degree elevation works by utilizing gravity to facilitate blood flow and drainage from the skull, potentially alleviating some of the swelling and pressure caused by herniation. This position does not compromise the spinal alignment since the patient is on a spinal board, which maintains spinal stability and protection. Other positioning options, such as lying completely flat, may worsen the situation by allowing pressure to build within the cranium, while elevating by just 15 degrees is unlikely to provide the significant benefit needed in an emergency with cerebral herniation. Lying on the side is generally not ideal in this situation as it does not provide the optimal orientation needed to manage intracranial pressure effectively. Thus, elevating the head by 30 degrees strikes a balance between comfort, safety, and effective management of the condition at hand.