"The Turn"

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I'm just wondering if anyone knows they physiology behind the "fatal turn" It's commonly heard that often times when someone is actively dying and you turn them, they often die soon after. I recently saw it for myself the other day. I had a pt where the family withdrew life support so we had the pt on supplemental oxygen and a Morphine gtt. He maintained stable vitals for about 3 1/2 hours after extubation. Then I finally decided to turn him and get him cleaned up (he had a lg BM) As soon as I was done his pulse started droppping and he lost palpable pulses and his BP. Within 15 min he was gone. Anyone know the physiological sequence of events that causes this???

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Specializes in Med-Surg.

I have always assumed it was related to fluid buildup, and patients not being able to compensate for the shift of fluid when repositioned if that makes any sense. But I have never actually read or heard a true reason.

A warm bath also eases patient quickly into death. And I assume (that work again) the warm water causes blood vessels to dilate, and BP to drop.

All of these are my silly little pea brain figuring, so I too would love to hear the real reason if anyone knows. :specs:

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Not able to think of the reasoning behind it now (I need a nap) but it is sooooooo true. happens just about all the time, after a nice bath or clean up due to inct.

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Specializes in Home Health, PDN, LTC, subacute.

That's funny because I worked with an older night nurse who swore she could keep patients alive until morning by turning them!

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Specializes in Nursing Home ,Dementia Care,Neurology..

Turning someone onto their left side can affect breathing.I have actually seen a paper on this and with post the link if I can find it.I will never turn someone onto their left if I know that their loved ones are coming in to be there for their final moments.I have seen quite a few people pass away within half an hour of being turned onto their left.

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Specializes in Community Health, Med-Surg, Home Health.
Turning someone onto their left side can affect breathing.I have actually seen a paper on this and with post the link if I can find it.I will never turn someone onto their left if I know that their loved ones are coming in to be there for their final moments.I have seen quite a few people pass away within half an hour of being turned onto their left.

If you fine the link, please post it! This is so interesting. And, it would teach me a great deal about bedside nursing in home care.

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Specializes in Telemetry, CCU.

Yes I am interested in why the left side would be the deal breaker. Hmm, left side for enemas, dumping syndrome and increasing placental perfusion, now left side speeds death? Interesting indeed.

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Specializes in Acute Care Psych, DNP Student.

I heard the opposite, that turning to the right side can bring a death on sooner.

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Specializes in Med/Surg, Ortho.

Ive seen it with turning to the left also. I dont know any documented reasoning behind it, but myself i have figured it had more to do with the pressure on the left side of the heart and the ability of an already weakened heart/body to supply adequate circulation when the bodys weight is resting on the left side of the heart. I dont know about fluid shifts simply because you would think that would be a longer process. Whatever it is is a fairly rapid reaction after turning.

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Specializes in med surg, LTC, ER , OB, PSYCH.
I'm just wondering if anyone knows they physiology behind the "fatal turn" It's commonly heard that often times when someone is actively dying and you turn them, they often die soon after. I recently saw it for myself the other day. I had a pt where the family withdrew life support so we had the pt on supplemental oxygen and a Morphine gtt. He maintained stable vitals for about 3 1/2 hours after extubation. Then I finally decided to turn him and get him cleaned up (he had a lg BM) As soon as I was done his pulse started droppping and he lost palpable pulses and his BP. Within 15 min he was gone. Anyone know the physiological sequence of events that causes this???

I always heard it was bwcause it puts more pressure on the heart!:innerconf

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Specializes in med surg, LTC, ER , OB, PSYCH.
I always heard it was because it puts more pressure on the heart! Mahes sense huh?:redpinkhe
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Specializes in Nursing Home ,Dementia Care,Neurology..

Cannot find the article!Most frustrating! Will keep looking.

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