Thank you and I have a general question and i won't ever forget your answers. What does it mean when a PT is tilted with the feet up all the way and is rushed to ICU? My question is about the action. I know your blood pressure is really low, this would initiate an RN to do this too the bed, but, to me, it seems you would have to have a point where you would initiate this action. At what point would you take such action? Is there a specific scenario for this, or does it just happen? What vitals would clue/dictate you to initiate this?
As a nurse, you would have to catch someones life, and I saw a PT just get whisked to ICU (with the bed tilted) but I was wondering if there is a signal for this event, cut and dried.
I know I (a CNA) can ask a nurse to ck the PT because the VT's are alarming, but what does an RN do then? What are VT #'s that would cause an RN to tilt the bed and take other immediate action? It sounds chalenging to be responsible to initiate a sequence to potentially save a life. Wow.
Seeing this left an impact on me, and I know I can't expect anyone to just explain it all to me in several sentences. I'd take any sentences i could get here. Is there a time when you would raise a persons head, and lower their feet?
Jun 30, '02
micro has the answers, but micro is off the clock.....
Mario, you know more than what you yourself credit for.........
hey, my fellow scholarly nurses..........
you are all better worded than I, and more knowledgeable.......
micro knows what micro knows, but just does it.......isn't and doesn't have the words..................
micro and out .....insomnia 101........think there is a post in this last phrase'
micro the nurse wants to retire and just go to that cabin on the hill'
Last edit by micro on Jun 30, '02
Jun 30, '02
I am by no means an expert; perhaps a cardiac nurse or someone with more experience could answer this more thoroughly for you. I do know that the position you are speaking of is called the 'Trendelenberg' Position. As you said, the patient's blood pressure had dropped significantly (which could indicate physiological shock and/or traumatic blood loss, possibly third-spaced blood loss), and the nurse flipped the patient so that their feet were up in the air. Basically what this does is allow gravity to push more blood more quickly to the heart while that patient is on their way to ICU. There are more aggressive treatments for serious hypotension, but this is one that is quick and easy to do before you have access to medication, volume expanders, etc. You asked what point at which you would take this action- I would assume immediately if the blood pressure was that low. If you are taking a BP and it is low, always consider that you may have the cuff positioned wrong or human error. You may want to confirm it with a manual BP if you are using a machine. Also look at the patient- if the BP has dropped severely, they will be experiencing symptoms of hypotension, including but not limited to dizziness or weakness. Once you have confirmed it, or are relatively sure that the reading is correct, you would go ahead and do this. It is a simple measure that cannot really hurt the patient while you evaluate what else to do. Sometimes, this position is contraindicated, as in a neuro trauma. If your patient has a head injury, you wouldn't want to have all the blood rushing back towards the heart because it would increase the intracranial pressure, etc. Other vitals or clues you might see are a weak, thready pulse (initially, with blood or volume loss, the pulse may be stronger as the heart works harder to pump blood, but as volume is lost, the pulse will weaken dramatically) or the patient may be sweating or pale. I don't know if a CNA can initiate this position or not; I don't work with adults. ;>) There are times when you would raise the head, but again, I'll leave that explanation to someone else who knows why. ;>P
Last edit by NICU_Nurse on Aug 28, '03