Penerapan Head Up terhadap Kesadaran Pasien Cedera Kepala di IGD RSUD Sayang Rakyat
DOI:
https://doi.org/10.33096/nthdvm87Keywords:
Head up 30°, glasgow coma scale, consciousness, head injuryAbstract
Head injury is a traumatic disturbance of brain function that may or may not be accompanied by interstitial bleeding within the brain substance (2,4,5). Emergency management aims to prevent secondary brain injury, including optimizing ventilation/oxygenation and cerebral perfusion, as well as patient positioning. A common non-invasive measure is 30° head elevation (Head-Up) to facilitate cerebral venous drainage. To describe changes in consciousness level (Glasgow Coma Scale/GCS) following the application of a 30° Head-Up position in a patient with moderate head injury in the emergency department. A single-patient case report in the emergency department of RSUD Sayang Rakyat Makassar. The primary Outcome was serial GCS recorded at baseline before elevation (T0) and during observation until transfer. Head-Up 30° was an independent nursing intervention; oxygen therapy was recorded as collaborative therapy. A 50-year-old male (Mr. R) with moderate head injury and subdural hemorrhage. At T0 (10:15 WITA) GCS was 3-3-5; at 10:45 WITA it remained 3-3-5; it increased to 3-3-6 at 12:50 WITA and remained 3-3-6 until 13:54 WITA when the patient was transferred to the operating room. Available observation lasted approximately 3 hours 39 minutes; the planned 8-hour follow-up was not completed due to definitive transfer. In this case, 30° head elevation (with collaborative oxygen therapy) was followed by an improvement in GCS from 3-3-5 to 3-3-6 during ED observation. As descriptive evidence, this report cannot establish causality but supports the use of 30° Head-Up as part of non-invasive early management for head injury.
References
1. Sufiani F. Literature Review: Pengaruh Pemberian Oksigenasi Dan Posisi Elevasi Kepala 300 Untuk Meningkatkan Kesadaran Pada Pasien Cedera Kepala. J Keperawatan [Internet]. 2021;1–9. Available from: https://osf.io/preprints/tfyjh/
2. Sinthiya N, Janes CP, Hariyono R. Hubungan Head Up Bed Dengan Tekanan Darah Dan Saturasi Oksigen Pada Pasien Penurunan Kesadaran Di ICU RSUD Wahidin Sudiro Husodo. [Internet]. repositori.ubs-ppni.ac.id; 2024. Available from: https://repositori.ubs-ppni.ac.id/handle/123456789/2638
3. Siregar B, Jundapri K, ... Asuhan Keperawatan Pada Pasien Cedera Kepala Dengan Peningkatan Tekanan Intrakranial Melalui Posisi Head Up 30. SENTRI J Ris Ilm [Internet]. 2023;2(11):4949–56. Available from: https://ejournal.nusantaraglobal.ac.id/index.php/sentri/article/view/1843
4. Ferenddito I. Pengaruh Head Up 300 terhadap Perubahan Saturasi Oksigen pada Pasien Cedera Kepala Berat. J Ilm Kesehat Media Husada [Internet]. 2025;14(1):95–102. Available from: https://ojs.widyagamahusada.ac.id/index.php/JIK/article/view/448
5. Susyanti D, Jundapri K, Siregar B, ... Head Up 30˚ in Head Injury Patients. Al-Asalmiya Nurs J Ilmu Keperawatan (Journal Nurs Sci [Internet]. 2023;12(2):178–83. Available from: https://jurnal.ikta.ac.id/keperawatan/article/view/2491
6. Utami MPS, Rahayu NW, ... Perubahan tingkat kesadaran pada pasien cedera kepala sedang (cks) dengan terapi oksigen dan posisi Head Up 30°: literatur review. J Keperawatan Notok usumo [Internet]. 2021;9(2):52–7. Available from: https://jurnal.stikes-notokusumo.ac.id/index.php/jkn/article/view/138
7. Putra ARAP, Harianja DD. Perdarahan Kepala Akibat Trauma. Termom J Ilm Ilmu Kesehat dan Kedokt [Internet]. 2025;3(2):124–38. Available from: https://doi.org/10.55606/termometer.v3i2.4922
8. Lin PC, Liu CY, Tzeng IS, Hsieh TH, Chang CY, Hou YT, et al. Shock index, modified shock index, age shock index score, and reverse shock index multiplied by Glasgow Coma Scale predicting clinical outcomes in traumatic brain injury: Evidence from a 10-year analysis in a single center. Front Med. 2022;9:999481.
9. Mehta NK. Head and Neck Injury Patterns among American Football Players. Ann Otol Rhinol Laryngol [Internet]. 2022;131(5):463–70. Available from: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85108299211&origin=inward
10. Hafid MA, Jamaluddin A. Intervensi Head Up 15-30 Derajat Terhadap Perfusi Serebral Pasien Traumatic Brain Injury: Studi Kasus. Alauddin Sci J Nurs. 2024;5(1):8–14.
11. Kanine E, Kiling MA, Tololiu TA, Merentek GA. Effectiveness of 30-Degree Head Up to Improve O2 Saturation in Severe Head Injury Patients. J Ilm Perawat Manad. 2023;11(2):143–53.
12. Supardi S, Pramono C. Laporan Studi Kasus pada Pasien dengan Cidera Kepala Ringan dengan Tindakan Posisi Universitas Muhammadiyah Klaten. Heal Soc Hum [Internet]. 2021;172–6. Available from: http://prosiding.umkla.ac.id/cohesin/index.php/home/article/view/82
13. Mukminin STS. … Farmakologi Dan Posisi Head Up 30° Pada Pasien Dengan Penurunan Kapasitas Adaptif Intrakranial Post Craniotomy Cidera Kepala … [Internet]. eprints.umm.ac.id; 2024. Available from: https://eprints.umm.ac.id/id/eprint/13377/
14. Zakiyah D, Wahdi A, Camelia D. Penerapan terapi Head Up 30 terhadap peningkatan saturasi oksigen pada CVA bleeding dengan masalah keperawatan penurunan kapasitas adaptif intrakranial. J Insa Cendekia [Internet]. 2023;10(3):211–9. Available from: http://digilib.itskesicme.ac.id/ojs/index.php/jic/article/view/1251
15. Wulandari NP, Widyaningsih W, ... Pemberian Oksigenasi NRM dan Posisi Head Up 30° Terhadap Tingkat Kesadaran dan Hemodinamik Pada Pasien Cedera Kepala. J Ilm Keperawatan Stikes Hang Tuah Surabaya [Internet]. 2023;18(2):118–27. Available from: http://journal.stikeshangtuah-sby.ac.id/index.php/JIKSHT/article/view/303
