List Archives

Fri Jan 19 16:32:18 GMT 2007

good point.rangraj
On 1/19/07, MARK FORREST <atacc.doc at btinternet.com> wrote:
>
> Dear Rangraj,
> The plastic, ENT and head & neck surgeons are generally asking for
> 'reverse trendelenburg' to reduce venous congestion, whereas shock and
> resuscitation remain something of a grey area for them!!
> Regards
> Mark
>
>
> ----- Original Message ----
> From: Rangraj Setlur <rangraj at gmail.com>
> To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
> Sent: Friday, 19 January, 2007 1:36:19 AM
> Subject: Re: Trendelenburg (was RE: IVC Filters, Coumadin, Plavix, ASA,
> Fragmin)
>
>
> Dear Dr Middleton,
> could you send me a copy as well? Just finished telling a plastic surgeon
> the trndelenburg position was completely useless, he wanted references.
> thanks.
> rangraj
>
> On 1/18/07, Paul Middleton <paul.middleton at usa.net> wrote:
> >
> > Ian
> >
> > Not sure if I can attach things to Trauma list emails so I have sent it
> to
> > your work email.
> >
> > Regards
> >
> > Paul
> >
> >
> > ------ Original Message ------
> > *Received: *Thu, 18 Jan 2007 12:23:05 PM EST
> > *From: *"Ian Seppelt" <SeppelI at wahs.nsw.gov.au>
> > *To: *<trauma-list at trauma.org>
> > *Subject: *Trendelenburg (was RE: IVC Filters, Coumadin, Plavix,ASA,
> > Fragmin)
> >
> >
> > Does anyone have access to Am J Crit Care who can send a pdf of this
> > paper? [Still frustratingly common to see this done in general wards]
> > Thanks, Ian
> >
> > Ian Seppelt FANZCA FJFICM
> > Senior Staff Specialist
> > Dept of Intensive Care Medicine
> > The Nepean Hospital, PO Box 63 Penrith NSW 2751
> > Clinical Lecturer, University of Sydney
> >
> > >>> pbjorn at emh.org 18/01/2007 6:10am >>>
> > 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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> >
> >
> > Dr Paul Middleton RGN MBBS FRCS(Eng) DipIMCRCS(Ed) FCEM FACEM, Staff
> > Specialist / Conjoint Senior Lecturer in Emergency Medicine, Public
> Health
> > and Community Medicine POWH / UNSW Sydney NSW
> >
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> >
>
>
> --
> Lt Col Rangraj Setlur
> Associate Professor
> Department of Anaesthesiology and Critical Care
> Armed Forces Medical College
> Pune
> India
> --
> trauma-list : TRAUMA.ORG
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>


-- 
Lt Col Rangraj Setlur
Associate Professor
Department of Anaesthesiology and Critical Care
Armed Forces Medical College
Pune
India

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Trendelenburg (was RE: IVC Filters, Coumadin, Plavix, ASA, Fragmin)