What is the recommended head of bed (HOB) elevation after a CVA?

After a cerebrovascular accident (CVA), commonly known as a stroke, the recommended head of bed elevation is 30 degrees. This position is generally preferred for several reasons related to patient safety and comfort.

Elevating the head of the bed to 30 degrees helps to optimize cerebral perfusion and reduce the risk of increased intracranial pressure, which is particularly important in the first days following a stroke. This elevation also assists in preventing complications such as aspiration pneumonia. When a patient has suffered a stroke, they may have impaired swallowing or motor function, making them at higher risk for aspiration if fluids or food enter the airway.

Additionally, a 30-degree elevation can promote better lung expansion, decreasing the likelihood of atelectasis and further respiratory complications. This position strikes a balance, allowing for adequate drainage of secretions while minimizing any undue pressure on a compromised cerebral circulation.

Adjustments to the head of bed elevation may be made based on the specific type of stroke (ischemic vs. hemorrhagic) and the patient's overall medical condition, but 30 degrees is a widely accepted standard for enhancing recovery and safety.