title: Head Position in the Early Phase of Acute Ischemic Stroke: An International Survey of Current Practice.
abstract: BACKGROUND
  Evidence to recommend a specific head position for patients in the early phase of acute ischemic stroke (AIS) is scarce. The aim of this study was to assess current head position practice for AIS patients among physicians from hospitals in different countries.
  
  
  METHODS
  A cross-sectional survey research design was used; physicians who are part of a stroke research network were invited to participate by e-mail. Descriptive statistics were used.
  
  
  RESULTS
  An invitation to participate was delivered to 298 doctors from 16 countries and 42.9% completed all survey questions. Participant responses were evenly divided in sitting up and lying flat position as the most usual at their hospital: 52.8% (95% confidence interval [CI], 43.7-61.0) of respondents preferred sitting up, whereas 47.2% (95% CI, 38.2-55.5) preferred lying flat; 53.9% (95% CI, 45.3-62.5) of participants answered that no written protocol specifying the indicated head position for stroke patients was available at their hospital or department, and 71% (95% CI, 63.2-78.9) recognized being uncertain about the best position for AIS patients.
  
  
  CONCLUSIONS
  Common practice differs between physicians, and there is a lack of consensus about the best strategy regarding head position for AIS patients in many countries. An opportunity exists for a randomized trial to resolve this uncertainty and develop evidence-based consensus protocols to improve patient management and outcomes.
authors.affiliation: Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia. Electronic address: pmventurelli@gmail.com.
authors.forename: Paula
authors.initials: P
authors.lastname: Muñoz Venturelli
authors.affiliation: Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
authors.forename: Verónica
authors.initials: V
authors.lastname: Olavarría
authors.affiliation: Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
authors.forename: Francisca
authors.initials: F
authors.lastname: González
authors.affiliation: Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Brunser
authors.affiliation: Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile; Departamento de Ciencias Neurológicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lavados
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D032921:Consensus; D003430:Cross-Sectional Studies; D005260:Female; D006257:Head; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000639:trends*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016683:Supine Position; D011795:Surveys and Questionnaires
keywords: Brain ischemia; cerebral hemorrhage; data collection; head position stroke; survey