[wv_nurse 2003]

We use a "modified" approach. We don't lower the head like we used to--but just flatten the HOB and raise the feet. Just a perfusion assist until we find the cause of the hypotension.

[gwenith]

There is an mirror thread of this in the Critical Care forums - I will merge the two threads.

[gwenith]

Sorry folks - All those who have been following the "informatics" thread will now have to read back to the other beginning

I just thought it would be better to have all the wonderful information in one thread rather than spread out.

[wishingmary]

Zee RN,

If you happen to run across your source for

"The Trendelenburg position, once favored in managing shock, has been abandoned because it allows the diaphragm to migrate upward, thus compromising ventilation. Also, this position may cause a reflex inhibition of the pressoreceptor activity, thereby decreasing sympathetic stimulation and further compromising arterial blood pressure."

Please post it.

Thanks,

Mary

[wishingmary]

To add to this thread, I found this:

"Trendelenberg position - displacement of the abdominal viscera pushes the diaphragm against the heart, which can result in hypotension. You get compression of lung bases by abdominal viscera and you can get increased peak airway pressures. You can see increased ICP in vulnerable patients due to decreased outflow from brain."

www.nurse-anesthesia.com/principlesnotes.htm

As I go through my pile of papers to find how the researchers used trendelenberg, I'll post them. Most of what I have is incidental, mentioned in articles about certain operative procedures. But I got some gems too. This thread has definitely been the best on this topic.

Thanks Gwenth et all,

Mary

[wishingmary]

Does anyone use Trendelenberg, meaning head down, straight legs up at any angle to reposition beriatric patients to the head of the bed? Is this recommended by experts? I see it & use it frequently.

Thanks for posting,

Mary