Trendelenburg

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jefftherealmccoy

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There's a thread about this already, but it hasn't been posted on since 2007. I'd like some new thoughts on it because I know there's been more info to come out.

I recently had a call where a senior medic had a talk with me because I didn't place the pt in Trendelenburg possition. I told him it was taught to me in medic school to no longer use the trendelenburg because it can actually cause a drop in pressure after the initial rise.

I'm in the process of getting hard facts and studies, but anyone got any new insight on this? and any articles would also be appreciated.
 
Always useful for moving patients up in bed. Sometimes useful for starting and removing central lines.

For hemorrhagic shock? We knew 10 years ago it wasn't useful, even though they were still teaching it.
 
jefftherealmccoy said:
There's a thread about this already, but it hasn't been posted on since 2007. I'd like some new thoughts on it because I know there's been more info to come out.

I recently had a call where a senior medic had a talk with me because I didn't place the pt in Trendelenburg possition. I told him it was taught to me in medic school to no longer use the trendelenburg because it can actually cause a drop in pressure after the initial rise.

I'm in the process of getting hard facts and studies, but anyone got any new insight on this? and any articles would also be appreciated.
Click to expand...

The cool kids these days call it Passive Leg Raising or Passive Leg Elevation. It has a transient effect that is not sustained.

If you enjoy nutty medicine, some people believe with all their hearts that PLE/Trendelenburg saves lives... (hat tip to KellyBracket)
 
Wasn't taught it in EMT class, however we were taught mast trousers again.

Pressure point for bleeding is out of date, but when I tested I threw in an ice pack for slowing down bleeding and confused my evaluator. I was taught it in class but it wasn't on the sheet.

I also use an opa as a tongue blade which just about failed me until I explained why I was using it. I then was given a kudos as I explained it pulled the tongue up and out of the way. I guess that's why talking is good in testing.

Yes the position is long gone. As is pressure points
 
Trendelenburg was taught in my EMT and Medic class too. Along with MAST trousers.

apparently were still waiting to get the updates to say hey we know it doesn't work. So stop teaching it.
 
To quote Joni MItchell (typo-pun unintended): "Everything comes and goes, marked by lovers and styles...".* Like tourniquets too.

ARC still teaches elevation of injured extremity and show the legs elevated by a prop the heels (ouch), but every time they revise, it gets lower. I joke with my classes that eventually it will be like 1 inch, 1/2 inch, then 1/4 inch...but no elevation for shock.

* http://www.youtube.com/watch?v=ovbNRvrnNDw
 
Here's a question, a little trivia....

Why did Friedrich Trendelenburg develop his namesake position? What was his goal in using this?

How does that apply to what we do as prehospital providers?

What we do, flexion of the legs at the hips, is not true Trendelenburg position anyway. I dont know of any ambulance cot that can apply the Trendelenburg position, only the modified
 
To move abdominal organs out of the way during surgery. The BP increase was just a welcome, although transient, side effect.
 
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