Do you use the trendelenberg position?

[wishingmary]

I am a nursing student and a nurse aide in the MICU. My last semester of nursing school requires I do an informal teaching project so I asked my manager if she could think of a teaching need in the units. She suggested the use of Trendelenberg (head down lying supine). Evidently there is some controversy about its appropriate use in the units. I have done some research and I don't find anything in nursing journals off the web specifically addressing its use. I have found Trendelenberg used when inserting a pulmonary catheter to reduce chances of a PE and of course there are some operating room instances. My clinical adviser told me I could use this board as a reference

So......

When do nurses in the units use Trendelenberg, at what angle, and how long do you maintain this position? I also want to know if you use it in cases of hypotension (along with hypotensive drugs) and whether it's benefit outweighs the risk of increased intracranial pressure in non-head trauma patients? Oh, another question I have is do your units allow its' use as a nursing intervention or is it treated as a collaborative intervention with an order from a physician?

By the way, I'm not doing an inservice since I would feel queer standing in front of seasoned ICU nurses so I'm doing a poster board. In order to evaluate the effectiveness of this teaching I'm leaving a quiz of 5 multiple choice questions. Hopefully I'll get some response by those who remember nursing school.

Thank you beforehand for all your replies to any or all questions presented here and for any criterias your units use on this subject.:)

Mary Bernhagen

[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."

http://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