Which action would NOT help reduce intracranial pressure?

• A. Elevate head of bed to 30 degrees
• B. Ensure airway and minimize stimulation
• C. Administer hyperventilation to the point of respiratory alkalosis
• D. Place patient in Trendelenburg position

Answer: (D)

Reducing intracranial pressure relies on promoting cerebral venous drainage, preserving an adequate airway, and avoiding factors that raise cerebral blood volume. Elevating the head of the bed to about 30 degrees helps drain venous blood from the brain, lowering ICP. Ensuring the airway and minimizing stimulation prevent hypoxia, hypercapnia, and agitation that can increase ICP. Hyperventilation lowers PaCO2, causing cerebral vasoconstriction and a temporary drop in intracranial blood volume, thereby reducing ICP (though it should be used carefully and short-term). Placing the patient in a head-down, feet-up position (Trendelenburg) increases cerebral venous pressure and blood volume in the brain, which raises ICP rather than lowers it. That makes it the action that would not help reduce ICP.