List Archives

Wed Jan 17 19:10:30 GMT 2007

I PubMedded ["Trendelenburg Position" AND Shock] for the past ten years,
yielding five references -- three of which were irrelevant and one of
which was a survey.  The last is abstracted below.

The data seems to suggest that there's no data.

Pret Bjorn, RN
Bangor, ME USA

Am J Crit Care. 2005 Sep;14(5):364-8.  Links 
Use of the Trendelenburg position as the resuscitation position: to T or
not to T?Bridges N, Jarquin-Valdivia AA. 
The Neurointensive Care Unit, Vanderbilt University Medical Center,
Nashville, TN, USA.

OBJECTIVE: To review the literature on use of the Trendelenburg position
as a position for resuscitation of patients who are hypotensive.
METHODS: PubMed online, cited bibliographies, critical care textbooks,
and Advanced Cardiac Life Support guidelines were searched for
information on the position used for resuscitation. Because of the
heterogeneity of the data, only pertinent articles and chapters were
summarized. RESULTS: Eight peer-reviewed publications on the position
used for resuscitation were found. Pertinent information from 2 critical
care textbooks and from the Advanced Cardiac Life Support guidelines was
included in the review. Literature on the position was scarce, lacked
strength, and seemed to be guided by "expert opinion." CONCLUSION: The
general "slant" of the available data seems to indicate that the
Trendelenburg position is probably not a good position for resuscitation
of patients who are hypotensive. Further clinical studies are needed to
determine the optimal position for resuscitation.

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Nappio at aol.com
Sent: Wednesday, January 17, 2007 10:33 AM
To: trauma-list at trauma.org
Subject: Re: IVC Filters, Coumadin, Plavix,ASA, Fragmin

Just yesterday, unrelated to this list, an orthopedic doc approached me
with 
this very complaint that his pt said his primary had to stay on the drug

forever with an IVC.   In yet another example of antiquated
interventions, I 
also arrived in my ICU to find my nurses had put my pt in  Trendelenberg
position 
which I thought was written out of text books.  can  someone please tell
me 
the best reference for avoiding Trendelenberg,  and  for my ortho
friend, can 
someone send the bundle of threads on the coumadin  discussion to either
my 
e-mail personally or repeat to the list,,thanks,,,Dave  Nap,,,MD, FACS
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Trendelenburg (was RE: IVC Filters, Coumadin, Plavix,ASA, Fragmin)