Login
Site Search
Subscribe

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes

 

Modify

Modify

 

Home > List Archives

List Archives

For your convenience, find the Trauma List Archive Below

Cease fire NOW or prehospital needle thoracotomy

Roy Danks roydanks at hotmail.com
Tue Aug 1 03:45:39 BST 2006 

> Subject: Re: Cease fire NOW or prehospital needle thoracotomy
> 
> I guess I stand corrected.  I got that information from a source I normally
> consider reliable.  It sounded reasonable so I believed it.
> 
> Is elevation of the lower extremities useful in hypoperfusion for those of
> us without the ability to introduce fluids?

It ain't about BP, it's all about cellular perfusion and reversing/preventing metabolic acidosis, ie: DO2


Ann Emerg Med. 1994 Mar;23(3):564-7. Links 
Trendelenburg position and oxygen transport in hypovolemic adults.Sing RF, O'Hara D, Sawyer MA, Marino PL. 
Department of Surgery, Graduate Hospital, Philadelphia.

STUDY OBJECTIVE: To evaluate the effect of the Trendelenburg position on oxygen transport in hypovolemic patients. DESIGN: A prospective, self-controlled sequential design. INTERVENTIONS: All patients had indwelling pulmonary artery catheters, and hypovolemia was confirmed by a pulmonary artery wedge pressure of 6 mm Hg or less. Hemodynamic and oxygen transport variables were measured with the patient supine and again ten minutes after placing the patient in the Trendelenburg position. SETTING: University-affiliated tertiary care surgical ICU. TYPE OF PARTICIPANTS: Eight postoperative adults. RESULTS: Mean arterial blood pressure increased from 64.9 +/- 4.9 to 75.6 +/- 3.5 mm Hg (P < .05), pulmonary artery wedge pressure increased from 4.6 +/- 1.1 to 7.9 +/- 0.8 mm Hg (P < .05), and the systemic vascular resistance rose to 2,965 +/- 210 from 2,302 +/- 199 dyne.sec/cm5 (P < .05). There was no significant change in cardiac index, oxygen delivery, oxygen consumption, or oxygen extraction ratio. CONCLUSION: The increase in blood pressure from Trendelenburg position is not associated with an improvement in blood flow or tissue oxygenation.



Why can you not introduce fluids?  Level of training?  Situation?  Please explain.

RRD

_________________________________________________________________
Try Live.com - your fast, personalized homepage with all the things you care about in one place.
http://www.live.com/getstarted

More information about the trauma-list mailing list