The Trendelenburg position is used in many hospital rooms. It consists in the fact that the patient’s body lies at an angle of 15 to 30 degrees to the head. It used to be common in medicine that it was a solution to centralize the circulation and was used as an anti-shock position. Today, it serves primarily to facilitate access to organs located in the upper body during examinations, operations, and other medical procedures. It is used, among others during X-ray of the upper gastrointestinal tract and to remove secretions lingering in the respiratory tract.
Name “Trendelenburg position«, Which is quite a long phrase, has a history behind it – also not of the short ones. It was invented in the XNUMXth century by a German surgeon Friedrich Trendelenburg. It is of great importance to adequately protect the patient when going to Trendelenburg position. Since its invention, this type of tilt has been used in many controversial therapies, the effectiveness of which sooner or later was negatively verified.
During the First World War Trendelenburg position has been used to transport patients in shock in the hope of increasing blood perfusion to vital organs. It was noted that this was not an appropriate way of positioning the injured, especially those with a respiratory problem, but it could make the situation even worse due to the pressure exerted by the abdominal organs. This can lead to an increase in intracranial pressure, which in turn may aggravate respiratory problems in people who have suffered brain injuries. It also turns out to be unfavorable in spinal injuries due to the high chance of aggravating the existing vertebral injuries.
It has been proven that the blood vessels of patients after shock are extremely constricted, so there is no question of effective use Trendelenburg position for autotransfusion of blood from the lower extremities to the higher organs.
Today’s ways of using the Trendelenburg position
On the other hand, this former anti-shock position has specialized applications even today. It provides adequate insight into the upper part of the digestive tract and is used in gynecology and dentistry. It is also useful in cardiac surgeries, abdominal hernia procedures and when locating the central puncture. Despite the fact that among the relatively long list of contraindications to its use there is also a different state, properly applied Trendelenburg position in pregnancy can be medically beneficial.
An important application of this position is also static postural drainage in cystic fibrosis and lung and bronchial diseases. Staying in Trendelenburg position allows for 45 to 60 minutes to drain the secretion. This process can be supported by tapping the patient’s chest area.
You can meet with anti-Trendelenburg position, also known as Reverse Trendelenburg position. In this case, the patient’s head is raised 15 to 30 degrees relative to his feet. The patient, positioned in this way, is prepared for operations where increased exposure is required in areas such as the prostate and upper abdominal cavity.
Reverse Trendelenburg position can be used to increase respiratory function in overweight and obese patients by reducing intracranial pressure. However, we should bear in mind that there is a risk of hypotension and reduced blood flow to the brain, neck and genital area.
Hospital comforts
In the case of hospital beds Trendelenburg position rather, it is intended to provide additional comfort to patients. Usually it is used to allow the patient to change position. People with reduced mobility have the option to use Trendelenburg position Built-in bed functions to make you feel comfortable. Similarly anti-Trendelenburg position is among the bed options. Thanks to the built-in Trendelenburg position it is possible to lift the legs, which brings relief to people whose blood flow to the feet is restricted – for example, in an advanced stage of pregnancy.
Unfortunately, also in this case, the use of these functions has its drawbacks and contraindications. It is recommended that patients do not spend too much time in this way, so it is important that for people with dementia or limited mental abilities it is important to use Trendelenburg position was controlled by a tutor. With this in mind, bed manufacturers have introduced a specialized locking mechanism that allows the position to be activated only after the personal authorization of the therapist.
The new replaces the old
In conclusion, the story Trendelenburg position it is certainly fascinating. Nevertheless, its importance in the medical world declined throughout the period of its use. The role of the anti-shock position was taken over by the so-called safe position – also other indicated applications have found more effective solutions over time, a Trendelenburg position He sees physiotherapy as a beneficial element in providing comfort to patients who require long-term care.